CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Shinichiro Miyoshi, Susumu Kanazawa

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. Methods: We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Results: Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Conclusion: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Key Points: • Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. • Complications are usually minor and asymptomatic. • A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

Original languageEnglish
Pages (from-to)114-121
Number of pages8
JournalEuropean Radiology
Volume26
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Keywords

  • Complications
  • Interventional radiology
  • Lung
  • Pneumothorax
  • Video-assisted thoracoscopic surgery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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