Pneumothorax: radiologic treatment with small catheters

Area of Science:

• Thoracic medicine
• Interventional radiology
• Pulmonary disease

Background:

• Standard treatment for symptomatic and large pneumothorax involves surgically placed large-bore chest tubes (22-32-F).
• Percutaneous lung biopsy is a common cause of pneumothorax requiring intervention.

Purpose of the Study:

• To evaluate the efficacy of small-caliber catheters for treating pneumothorax resulting from percutaneous lung biopsy.
• To assess the feasibility of image-guided small catheter insertion by radiologists.

Main Methods:

• Retrospective analysis of 30 patients with pneumothorax (15 under tension) post-percutaneous lung biopsy.
• Treatment involved small catheters (7, 8.2, and 9.4 F) inserted under computed tomographic or fluoroscopic guidance.
• Catheters were used for large (>35%) or symptomatic pneumothoraces.

Main Results:

• Twenty-eight of 30 patients (93.3%) were successfully treated with small catheters alone.
• Two patients required delayed surgical placement of large-bore tubes due to incomplete pneumothorax resolution.
• Small catheters were inserted expeditiously by radiologists in the radiology department.

Conclusions:

• Small-caliber catheters are effective for decompressing pneumothoraces, including those resulting from lung biopsies.
• This minimally invasive technique can be rapidly performed by radiologists, offering a viable alternative to traditional chest tubes.