Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.

OBJECTIVES:To evaluate frequency and severity of complications after CT-guided lung biopsy using the Society of Interventional Radiology (SIR) classification, and to assess risk factors for overall and major complications. MATERIALS AND METHODS:311 consecutive biopsies with a non-coaxial semi-automa...

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Main Authors: Amany Saad Elshafee, Annika Karch, Kristina I Ringe, Hoen-Oh Shin, Hans-Jürgen Raatschen, Nermin Yehia Soliman, Frank Wacker, Jens Vogel-Claussen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0213990
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spelling doaj-980359ae90ba4f36b2da3d25ac60e4492021-03-03T20:48:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01143e021399010.1371/journal.pone.0213990Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.Amany Saad ElshafeeAnnika KarchKristina I RingeHoen-Oh ShinHans-Jürgen RaatschenNermin Yehia SolimanFrank WackerJens Vogel-ClaussenOBJECTIVES:To evaluate frequency and severity of complications after CT-guided lung biopsy using the Society of Interventional Radiology (SIR) classification, and to assess risk factors for overall and major complications. MATERIALS AND METHODS:311 consecutive biopsies with a non-coaxial semi-automated 18 gauge biopsy system were retrospectively evaluated. Complications after biopsy were classified into minor SIR1-2 and major SIR3-6. Studied risk factors for complications were patient-related (age, sex and underlying emphysema), lesion-related (size, location, morphologic characteristic, depth from the pleura and histopathology), and technique-related (patient position during procedure, thoracic wall thickness at needle path, procedure time length and number of procedural CT images, number of pleural passes, fissure penetration and needle-to-blood vessel angle). Data were analyzed using logistic and ordinal regression. RESULTS:Complications were pneumothorax and pulmonary hemorrhage. The complications were minor SIR1-2 in 142 patients (45.6%), and major SIR3-4 in 25 patients (8%). SIR5-6 complications were not present. Emphysema, smaller deeply located lesion, increased puncture time length and number of procedural CT images, multiple pleural passes and fissure puncture were significant risk factors for complication severity in univariate analysis. Emphysema (OR = 8.8, p<0.001), lesion depth from the pleura (OR = 1.9 per cm, p<0.001), and fissure puncture (OR = 9.4, p = 0.01) were the independent factors for major complications in a multiple logistic regression model. No statistical difference of complication rates between the radiologists performing biopsies was observed. CONCLUSIONS:Knowledge about risk factors influencing complication severity is important for planning and performing CT-guided lung biopsies.https://doi.org/10.1371/journal.pone.0213990
collection DOAJ
language English
format Article
sources DOAJ
author Amany Saad Elshafee
Annika Karch
Kristina I Ringe
Hoen-Oh Shin
Hans-Jürgen Raatschen
Nermin Yehia Soliman
Frank Wacker
Jens Vogel-Claussen
spellingShingle Amany Saad Elshafee
Annika Karch
Kristina I Ringe
Hoen-Oh Shin
Hans-Jürgen Raatschen
Nermin Yehia Soliman
Frank Wacker
Jens Vogel-Claussen
Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.
PLoS ONE
author_facet Amany Saad Elshafee
Annika Karch
Kristina I Ringe
Hoen-Oh Shin
Hans-Jürgen Raatschen
Nermin Yehia Soliman
Frank Wacker
Jens Vogel-Claussen
author_sort Amany Saad Elshafee
title Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.
title_short Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.
title_full Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.
title_fullStr Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.
title_full_unstemmed Complications of CT-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: Frequency, severity and risk factors.
title_sort complications of ct-guided lung biopsy with a non-coaxial semi-automated 18 gauge biopsy system: frequency, severity and risk factors.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2019-01-01
description OBJECTIVES:To evaluate frequency and severity of complications after CT-guided lung biopsy using the Society of Interventional Radiology (SIR) classification, and to assess risk factors for overall and major complications. MATERIALS AND METHODS:311 consecutive biopsies with a non-coaxial semi-automated 18 gauge biopsy system were retrospectively evaluated. Complications after biopsy were classified into minor SIR1-2 and major SIR3-6. Studied risk factors for complications were patient-related (age, sex and underlying emphysema), lesion-related (size, location, morphologic characteristic, depth from the pleura and histopathology), and technique-related (patient position during procedure, thoracic wall thickness at needle path, procedure time length and number of procedural CT images, number of pleural passes, fissure penetration and needle-to-blood vessel angle). Data were analyzed using logistic and ordinal regression. RESULTS:Complications were pneumothorax and pulmonary hemorrhage. The complications were minor SIR1-2 in 142 patients (45.6%), and major SIR3-4 in 25 patients (8%). SIR5-6 complications were not present. Emphysema, smaller deeply located lesion, increased puncture time length and number of procedural CT images, multiple pleural passes and fissure puncture were significant risk factors for complication severity in univariate analysis. Emphysema (OR = 8.8, p<0.001), lesion depth from the pleura (OR = 1.9 per cm, p<0.001), and fissure puncture (OR = 9.4, p = 0.01) were the independent factors for major complications in a multiple logistic regression model. No statistical difference of complication rates between the radiologists performing biopsies was observed. CONCLUSIONS:Knowledge about risk factors influencing complication severity is important for planning and performing CT-guided lung biopsies.
url https://doi.org/10.1371/journal.pone.0213990
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