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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.
Purpose:
To evaluate the effectiveness of tract embolization (TE) in preventing pneumothorax and chest tube placement after computed tomography (CT)-guided percutaneous lung biopsy.
Materials And Methods:
PubMed, Embase, Web of Science, and Cochrane Library were searched through March 2025 for studies comparing TE versus no embolization. Risk ratio (RR) with 95% CI was pooled using random-effects models. Absolute risk reduction and number needed to treat were calculated using the control event rate. Subgroup analyses were performed by embolic agent, study design, and chest tube placement criteria. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. All analyses were conducted in R.
Results:
A total of 26 studies comprising 10,689 patients were included, of whom 5,066 underwent TE. TE was associated with a lower risk of pneumothorax (RR, 0.59; 95% CI, 0.53-0.65; P < .001; I2 = 33%), with blood patch (RR, 0.62; 95% CI, 0.51-0.76; I2 = 48.9%) and gelatin sponge (RR, 0.56; 95% CI, 0.47-0.66; I2 = 31.8%). TE also reduced chest tube placement (RR, 0.47; 95% CI, 0.37-0.58; P < .001; I2 = 32.9%), with blood patch (RR, 0.47; 95% CI, 0.33-0.67; I2 = 30%) and gelatin sponge (RR, 0.48; 95% CI, 0.31-0.73; I2 = 42.3%).
Conclusions:
TE after CT-guided percutaneous lung biopsy was associated with reduced pneumothorax and chest tube placement rates, with consistent reductions across blood patch, gelatin-based agents, and hydrogel. These findings support TE as an effective adjunct to reduce procedure-related complications.
