Efficacy of Tract Embolization After Percutaneous Pulmonary Radiofrequency Ablation

Cardiovasc Intervent Radiol. 2021 Jun;44(6):903-910. doi: 10.1007/s00270-020-02745-6. Epub 2021 Jan 25.

Abstract

Purpose: To evaluate the efficacy of tract embolization technique using gelatin sponge slurry with iodinated contrast medium (GSSI) to reduce the incidence of pneumothorax and chest tube placement after computed tomography-guided lung radiofrequency ablation (RFA).

Materials and methods: In this single-institute retrospective study, we examined all patients with metastatic cancer treated from January 2016 to December 2019 by interventional radiologists with computed tomography-guided lung RFA. Since 2017 in our institution, we have applied a tract embolization technique using GSSI for all RFA. Patients were included into those who underwent lung RFA performed either with GSSI (Group A) or without GSSI (Group B). Univariate and multivariate analyses were performed between the two groups to identify risk factors for pneumothorax and chest tube placement, including patient demographics and lesion characteristics.

Results: This study included 116 patients (54 men, 62 women; mean age, 65 ± 11 years) who underwent RFA. Group A comprised 71 patients and Group B comprised 45 patients. Patients who underwent tract embolization had a significantly lower incidence of pneumothorax (Group A, 34% vs. Group B, 62%; p < 0.001) and chest tube insertion (Group A, 10% vs. Group B, 29%; p < 0.01). No embolic complications occurred. The hospitalization stay was significantly shorter in patients who underwent tract embolization (mean, 1.04 ± 0.2 days; p = 0.02).

Conclusion: Tract embolization after percutaneous lung RFA significantly reduced the rate of post-RFA pneumothorax and chest tube placement and was safer than the standard lung RFA technique.

Keywords: Cancer; Chest tube; Gelfoam; Lung; Percutaneous radiofrequency ablation; Pneumothorax.

MeSH terms

  • Aged
  • Embolization, Therapeutic / methods*
  • Female
  • Gelatin
  • Humans
  • Length of Stay
  • Lung / diagnostic imaging
  • Lung / surgery
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / surgery
  • Lung Neoplasms / therapy*
  • Male
  • Pneumothorax / prevention & control*
  • Radiofrequency Ablation / methods*
  • Radiography, Interventional / methods
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Gelatin