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Computed tomography-guided pericardiocentesis: utility in the management of malignant pericardial effusion

Edward T D Hoey1, Kshitij Mankad

  • 1Academy of Radiology, Leeds General Infirmary Hospital, Yorkshire, United Kingdom. edwardhoey1@gmail.com

The American Journal of Emergency Medicine
|March 13, 2010
PubMed

Insights

Computed tomography (CT)-guided pericardiocentesis offers an alternative for draining pericardial effusions when echocardiography is not feasible. This CT-directed approach successfully managed a malignant pericardial effusion in an emergent case.

Area of Science:

  • Cardiology
  • Radiology
  • Interventional Procedures

Background:

  • Transthoracic echocardiography is the standard for diagnosing and guiding drainage of pericardial effusions.
  • Technical and patient-related factors can limit echocardiographic guidance for pericardiocentesis.

Observation:

  • A case of a malignant pericardial effusion requiring emergent drainage is presented.
  • Echocardiographic guidance was not feasible for this patient.

Findings:

  • Computed tomography (CT)-guided pericardiocentesis using the Seldinger technique provided successful drainage.
  • CT guidance overcomes limitations associated with echocardiography in specific patient scenarios.

Implications:

  • CT-directed pericardiocentesis is a viable alternative for pericardial effusion drainage.
  • Clinicians should consider CT guidance for emergent pericardiocentesis when echocardiography is contraindicated or technically challenging.

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