Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies

PURPOSE: To evaluate outcomes of CT fluoroscopy-guided core lung biopsies with emphasis on diagnostic yield, complications, and efficacy of parenchymal and pleural blood patching to avoid chest tube placement. METHODS: This is a single-center retrospective analysis of CT fluoroscopy-guided percutaneous core lung biopsies between 2006 and 2020. Parenchymal blood patching during introducer needle withdrawal was performed in 74% of cases as a preventative measure, and pleural blood patching was the primary salvage maneuver for symptomatic or growing pneumothorax in 60/83 (72.2%) of applicable cases. RESULTS: A total of 1029 patients underwent 1112 biopsies (532 men, mean age 66 years, 38.6% history of emphysema, lesion size=16.7 mm). The diagnostic yield was 93.6% (1032/1103). Fewer complications requiring intervention were observed in patients who had undergone parenchymal blood patching (5.7 vs. 14.2%, p