ASPIRATION OF A LARGE PNEUMOTHORAX RESULTING FROM TRANSTHORACIC NEEDLE-BIOPSY

PURPOSE: To determine whether simple aspiration of air from the pleura l space could obviate chest tube placement in patients with a large pn eumothorax after transthoracic needle biopsy. MATERIALS AND METHODS: S eventeen patients, who developed a large pneumothorax (> 30%) during c omputed tomographic (CT)-guided transthoracic needle biopsy and otherw ise would have required chest tube placement, underwent percutaneous a spiration of the pneumothorax while on the CT scanner table. Air was a spirated from the pleural space by using an 18-gauge intravenous cathe ter attached to a three-way stopcock and a 50-mL syringe. The patients were positioned with the puncture site down after aspiration of the p neumothoraces and oxygen was administered both during and after the pr ocedure. RESULTS: The pneumothorax was almost completely aspirated in all 17 patients. Twelve (70%) patients did not require chest tube plac ement. Follow-up chest radiographs obtained 2 and 4 hours after the pr ocedure revealed complete or almost complete resolution of the pneumot horax in eight (47%) patients and partial recurrence of a small, stabl e pneumothorax in four (24%) patients. The remaining five (29%) patien ts had recurrence of their pneumothorax, which ultimately required che st tube placement. CONCLUSION: Percutaneous catheter aspiration of a l arge biopsy-induced pneumothorax is safe and easy to perform and may o bviate chest tube placement.