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Published on: March 30, 2015
Fine needle assisted puncture positioning technique for CT-guided percutaneous interventions
Qingqing Wang1, Huanjing Wang1, Jian Zhang1
1Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, China.
Objective:
This study evaluated the feasibility and safety of a fine-needle-assisted, two-step puncture technique developed to improve accuracy in CT-guided percutaneous interventions at challenging target locations, compared with conventional approaches.
Methods:
In this retrospective study, CT-guided procedures-including biopsy, preoperative localization, microwave ablation, or percutaneous vertebroplasty-were performed on 40 patients with challenging target locations. In the fine-needle-assisted group, a 20/22-gauge initial fine needle was positioned near the target under CT guidance to serve as a guide. The secondary needle -such as a coaxial biopsy needle, microwave antenna, or bone puncture needle-was then introduced along the same trajectory and angle as the fine needle. The conventional approach involved a direct, stepwise needle insertion toward the lesion in 20 patients with challenging target locations. The number of repositioning attempts for the coaxial needle, microwave ablation antenna, and bone puncture needle, as well as the puncture time, were compared between the two groups. Puncture success rates and complications were recorded.
Results:
In the fine-needle-assisted group, initial fine-needle placement was successful in all 20 cases, allowing subsequent puncture of the target lesions. In the conventional approach group, one puncture failure was recorded. No major complications-such as massive pneumothorax, significant hemorrhage, or injury to major vessels or nerves-occurred in either group. The fine needle assisted group required fewer repositioning attempts and shorter puncture times than the conventional approach group, 0.9 ± 0.7 vs. 2.2 ± 1.3 times(p < 0.05) and 12.05 ± 2.86 vs. 14.95 ± 3.32 minutes(p < 0.05), respectively.
Conclusion:
The fine-needle-assisted puncture technique offers a safe, feasible, and effective means of improving precision in CT-guided percutaneous procedures at challenging target locations compared with conventional approaches.
