title: Bending percutaneous drainage catheters to facilitate CT-guided insertion using curved trocar technique.
abstract: To assess the safety and efficacy of placing thoraco-abdominal drainage catheters under CT-guidance using a curved trocar technique.
  
  
  
  A retrospective study of 182 CT/CT-fluoroscopy-guided thoraco-abdominal catheter drainages was conducted; half were performed by residents or fellows under the supervision of one radiologist (Group 1) and the other half under the supervision of 10 other radiologists (Group 2). Group 1 procedures employed a curved catheter assembly placed using trocar technique (n = 44) or straight catheters placed with Seldinger technique (n = 47). Group 2 procedures employed a straight catheter placed using trocar technique (n = 16) or straight catheters placed with Seldinger technique (n = 75). Technical success, procedure time, radiation dose (CT Dose Index CTDIvol), and adverse events (Common Terminology Criteria for Adverse Events, 4.0) were compared between techniques and groups using Student's t test, Fisher's exact test or Chi-square analysis.
  
  
  
  All procedures in groups 1 and 2 were technically successful. Mean procedure time for Group 1 curved trocar technique (28 ± 8 min) was shorter than groups 1 and 2 Seldinger technique (37 ± 11 min, p = .00002). Mean CTDIvolfor Group 1 curved trocar technique (107.8 ± 54.2 mGy) was lower than groups 1 and 2 Seldinger technique (136.1 ± 99.7 mGy, p = 0.032). Adverse event rates for curved trocar, straight trocar, and Seldinger techniques were 2.3% (1/44), 0% (0/16), and 3.3% (4/122), respectively (p = 1); all were grade 1 or 2, and no catheter malfunctions occurred.
  
  
  
  The curved catheter trocar technique is a safe and effective modification of the standard trocar technique that may facilitate CT-guided procedures impeded by CT gantry size limitations.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Young
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA. pshyn@bwh.harvard.edu.
authors.forename: Paul B
authors.identifier: http://orcid.org/0000-0003-0538-2151
authors.initials: PB
authors.lastname: Shyn
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
authors.forename: Oren W
authors.initials: OW
authors.lastname: Johnson
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
authors.forename: Nisha I
authors.initials: NI
authors.lastname: Sainani
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Nawfel
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation*; D004066:Digestive System Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014570:Urologic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*
keywords: Abdominal abscess; CT-guided; Catheter drainage; Pneumothorax; Trocar