Efficacy of a Self-expanding Tract Sealant Device in the Reduction of Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsy: A Matched Controlled Study Using Propensity Score Analysis
Judy U Ahrar, Sanjay Gupta, Joe E Ensor, Armeen Mahvash, Sharjeel H Sabir, Joseph R Steele, Stephen E McRae, Rony Avritscher, Steven Y Huang, Bruno C Odisio, Ravi Murthy, Kamran Ahrar, Michael J Wallace, Alda L Tam, Judy U Ahrar, Sanjay Gupta, Joe E Ensor, Armeen Mahvash, Sharjeel H Sabir, Joseph R Steele, Stephen E McRae, Rony Avritscher, Steven Y Huang, Bruno C Odisio, Ravi Murthy, Kamran Ahrar, Michael J Wallace, Alda L Tam
Abstract
Purpose: To evaluate the use of a self-expanding tract sealant device (BioSentry™) on the rates of pneumothorax and chest tube insertion after percutaneous lung biopsy.
Materials and methods: In this retrospective study, we compared 318 patients who received BioSentry™ during percutaneous lung biopsy (treated group) with 1956 patients who did not (control group). Patient-, lesion-, and procedure-specific variables, and pneumothorax and chest tube insertion rates were recorded. To adjust for potential selection bias, patients in the treated group were matched 1:1 to patients in the control group using propensity score matching based on the above-mentioned variables. Patients were considered a match if the absolute difference in their propensity scores was ≤equal to 0.02.
Results: Before matching, the pneumothorax and chest tube rates were 24.5 and 13.1% in the control group, and 21.1 and 8.5% in the treated group, respectively. Using propensity scores, a match was found for 317 patients in the treatment group. Chi-square contingency matched pair analysis showed the treated group had significantly lower pneumothorax (20.8 vs. 32.8%; p = 0.001) and chest tube (8.2 vs. 20.8%; p < 0.0001) rates compared to the control group. Sub-analysis including only faculty who had >30 cases of both treatment and control cases demonstrated similar findings: the treated group had significantly lower pneumothorax (17.6 vs. 30.2%; p = 0.002) and chest tube (7.2 vs. 18%; p = 0.001) rates.
Conclusions: The self-expanding tract sealant device significantly reduced the pneumothorax rate, and more importantly, the chest tube placement rate after percutaneous lung biopsy.
Keywords: Biosentry; Chest tube placement; Lung biopsy; Pneumothorax.
Conflict of interest statement
Authors #1–13 declare they have no conflict of interest. Author #14 is a medical monitor for Galil Medical and receives research support from Angiodynamics.
Source: PubMed