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Tract Embolization versus No Embolization after CT-Guided Lung Biopsy: A Systematic Review and Meta-Analysis
Bernard Campos Araruna Giancristoforo1, Davi Barbosa Pereira da Silva2, Maria Clara Merighi3
1Rede D'Or São Luiz, Rio de Janeiro, Brazil; Rivoa Interventional Radiology Group, Rio de Janeiro, Brazil.
Summary
Tract embolization significantly reduces pneumothorax and the need for chest tube placement after CT-guided lung biopsies. This procedure is an effective method to decrease complications from lung biopsies.
Area of Science:
- Interventional Radiology
- Pulmonary Medicine
- Medical Imaging
Background:
- CT-guided percutaneous lung biopsy is a common diagnostic procedure.
- Pneumothorax and subsequent chest tube placement are significant complications.
- Minimizing these complications is crucial for patient outcomes and healthcare efficiency.
Purpose of the Study:
- To evaluate the efficacy of tract embolization (TE) in preventing pneumothorax.
- To assess the impact of TE on the requirement for chest tube placement after lung biopsy.
- To synthesize evidence from multiple studies on TE's effectiveness.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials and observational studies.
- Searched major databases (PubMed, Embase, Web of Science, Cochrane Library) through March 2025.
- Pooled risk ratios (RR) using random-effects models and calculated absolute risk reduction (ARR) and number needed to treat (NNT).
Main Results:
- Included 26 studies with 10,689 patients (5,066 underwent TE).
- TE significantly reduced pneumothorax risk (RR 0.59) and chest tube placement (RR 0.47).
- Consistent benefits observed with blood patch and gelfoam agents across various study designs.
Conclusions:
- Tract embolization is an effective adjunct to CT-guided percutaneous lung biopsy.
- TE demonstrably lowers rates of pneumothorax and chest tube placement.
- The findings support the routine adoption of TE to improve procedural safety.
