Image-guided drainage of pericardial effusions in oncology patients

Alda Tam, Joe E. Ensor, Holly Snyder, Sanjay Gupta, Jean Bernard Durand, Michael J. Wallace

    Research output: Contribution to journalArticle

    6 Scopus citations

    Abstract

    The purpose of this study was to report our clinical experience with image-guided drainage of pericardial effusions in oncology patients. IRB approval was obtained for this retrospective, HIPAA-compliant study. From November 2002 to January 2008, 40 patients underwent 43 image-guided drainages of pericardial effusions. The medical records were reviewed to analyze the technical aspects of the procedures, complications, and clinical outcomes. Thirty-three pericardial drains were placed and 10 pericardiocenteses were performed. The technical success rate was 100%. Thirty-three procedures were performed under computed tomographic (CT) guidance, five under ultrasound (US) guidance, and five using both CT and US guidance. There were no technical, procedure-related complications. Delayed postprocedure complications and arrhythmias occurred in 11 cases, for an overall complication rate of 25.6%. All complications occurred in patients who had undergone drain placement. Nine patients developed new or worsening arrhythmias and six of these patients required transfer to a higher level of care or the initiation of pharmacological management. In 58.6% of drain placements, including 4 of 11 patients who developed complications, the catheter could have been removed earlier. The median overall survival was 6.47 months (95% CI: 2.37, 12.7). In conclusion, image-guided pericardial drain placement is safe and feasible. Due to the frequency of delayed postprocedure arrhythmias, follow-up monitoring in a telemetry unit is recommended. Prompt catheter removal after drainage may reduce the incidence of delayed post-catheter-insertion arrhythmias.

    Original languageEnglish (US)
    Pages (from-to)1217-1226
    Number of pages10
    JournalCardioVascular and Interventional Radiology
    Volume32
    Issue number6
    DOIs
    StatePublished - Nov 1 2009

    Keywords

    • Neoplasm
    • Percutaneous drainage
    • Pericardial drain
    • Pericardial effusion
    • Pericardiocentesis

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Cardiology and Cardiovascular Medicine

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  • Cite this

    Tam, A., Ensor, J. E., Snyder, H., Gupta, S., Durand, J. B., & Wallace, M. J. (2009). Image-guided drainage of pericardial effusions in oncology patients. CardioVascular and Interventional Radiology, 32(6), 1217-1226. https://doi.org/10.1007/s00270-009-9594-7