Intercostal artery laceration during thoracocentesis: increased risk in elderly patients

Two cases of intercostal artery laceration following thoracocentesis are reported. Subsequent analysis of 29 thoracic aortograms demonstrated a definite trend toward increasing tortuosity of intercostal arteries with advancing age. Consequently, the amount of space available for safe insertion of the thoracocentesis needle tends to decrease with advancing age. As a result, elderly patients are more prone to intercostal artery laceration during thoracocentesis, and careful attention must be paid to the proper technique for performing this examination in such patients.