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Ann Thorac Surg 1987;43:406-408
© 1987 The Society of Thoracic Surgeons

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Articles

Complications of Transthoracic Needle Biopsy Decreased with Isobutyl 2-Cyanoacrylate: A Pilot Study

Section of Pulmonary Diseases and Laboratory Medicine, Department of Medicine, Sinai Hospital of Detroit, Detroit, MI

Accepted for publication June 30, 1986.

^* Address reprint requests to Dr. Skupin, Section of Pulmonary Diseases, Department of Internal Medicine, Sinai Hospital of Detroit, 6767 W Outer Dr, Detroit, MI 48235-9978

To explore the possibility of performing percutaneous lung biopsy safely in patients mechanically ventilated with positive-end expiratory pressure (PEEP), transthoracic needle biopsy was performed in 16 anesthetized mongrel dogs mechanically ventilated with 10 cm H₂O of PEEP. To obtain the biopsy sample, a 25-gauge "skinny needle" was passed through a 20-gauge sheath and placed up to 6.25 cm deep. After satisfactory samples were obtained, both needles were withdrawn in the control group, but in the treated group, the outer sheath was used to inject 0.5 ml of isobutyl 2-cyanoacrylate to seal the needle track. Pneumothorax was present in 7 (87.5%) of 8 dogs in the control group and in 2 (25%) of 8 dogs in the treated group (p = .0147). Lung tissue exhibited an apparent foreign-body granulomatous inflammatory reaction. This technique could extend the benefits of transthoracic needle biopsy to mechanically ventilated patients, but further studies to prove the safety of isobutyl 2-cyanoacrylate are necessary.

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