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CT-Guided Tube Pericardiostomy Effective for Pericardial Effusion, Less Invasive

LEESBURG, Va -- September 21, 2009 -- A minimally invasive procedure, computed tomography (CT)-guided tube pericardiostomy is just as effective as the standard invasive surgical drainage technique for pericardial effusion.

In addition, the noninvasive procedure requires no recovery time, fewer resources, and provides an 89% cost savings over the surgical drainage technique, according to a study published in the October issue of the American Journal of Roentgenology.

"Patients having the procedure required only local anaesthesia and no post-treatment recovery time," said lead author Suzanne L. Palmer, MD, University of Southern California Keck School of Medicine, Los Angeles, California.

"Comparison of procedure charges at our institution showed an 89% cost savings with CT-guided tube pericardiostomy instead of surgical drainage."

For the study, researchers retrospectively reviewed 39 CT-guided tube pericardiostomy procedures in 36 patients during a 4-year period. Of the patients, 33 (92%) had undergone major cardiothoracic surgery, and 3 (8%) had undergone minimally invasive procedures.

Medical records were retrospectively reviewed for clinical presentation, surgical history, imaging studies performed, procedural details, fluid characterisation, and outcome.

All 39 CT-guided tube pericardiostomy procedures were performed successfully without clinically significant complications. After 33 of the 39 procedures (85%), symptoms did not recur after the catheter was removed. Three of the 36 patients (8%) had a recurrence of pericardial effusion and 8 patients (21% of procedures) needed pleural drainage procedures, all of which were performed in the CT suite immediately after the tube pericardiostomy procedure.

"Pericardial effusion occurs in as many as 85% of patients following cardiovascular surgery. CT-guided tube pericardiostomy is an attractive first-line therapeutic option for these patients, especially in the postoperative period because it spares them from having another invasive surgery," she said.

"Aside from being cost competitive it also makes the treatment option less risky for patients. The procedure does not require general anaesthesia and a catheter is inserted into the excess fluid for drainage, allowing physicians to avoid working around major organs and vascular structures," said Dr. Palmer.

SOURCE: American Roentgen Ray Society

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