Tract injection of autologous blood (intraparenchymal blood patching) in percutaneous transthoracic CT-guided lung biopsy and the incidence of pneumothorax: a retrospective analysis

Background: Pneumothorax is a common complication following percutaneous transthoracic computed tomography (CT)-guided lung biopsy. The purpose of this study is to determine if intraparenchymal blood (IPB) patching following the lung biopsy procedure causes a significant decrease in the incidence of post-biopsy pneumothorax, chest tube placement, and hospitalization. Methods: Retrospective analysis was performed on all percutaneous CT-guided lung biopsies completed between January 2013 and January 2020 at two hospitals. 309 patients received IPB and 227 did not. Cases were excluded if patients were younger than eighteen years-of-age, if an alternative method to seal the tract was utilized, an indwelling chest tube was already in place, or aerated lung parenchyma was not traversed by the needle. Retrospective review of records was performed to determine the overall incidence of post-biopsy pneumothorax, chest tube placement, and hospitalization when IPB was and was not administered. Results: Patients who received post-biopsy IPB had a statistically significant lower incidence of pneumothorax [45 of 309 (14.6%) vs. 84 of 227 (37.0%); P<0.0001], chest tube placement [12 of 309 (3.9%) vs. 39 of 227 (17.2%); P<0.0001], and hospital admissions [9 of 309 (2.9%) vs. 37 of 227 (16.4%); P<0.0001] than those who did not. Conclusions: Autologous IPB following percutaneous transthoracic CT-guided lung biopsy significantly decreases the incidence of pneumothorax, chest tube placement, and hospital admission.