Novel Use of Extrapleural Autologous Blood Injection in CT-Guided Percutaneous Lung Biopsy and its Comparison to Intraparenchymal Autologous Blood Patch Injection: A Single-Center, Prospective, Randomized, and Controlled Clinical Trial

Abstract

Purpose To evaluate the rate of iatrogenic pneumothorax and the need for intervention with extrapleural autologous blood injection (EPABI) along with intraparenchymal autologous blood patch injection (IABPI) or IABPI-only in CT-guided percutaneous lung biopsy. Materials and Methods One hundred and thirty-nine participants were referred for CT-guided percutaneous lung biopsy, and 81 were randomized into study (EPABI + IABPI,n = 40) and control (IABPI-only,n = 41) groups. In the study group, similar to 5 ml of autologous blood was injected into the extrapleural space before passing through the parietal and visceral pleura. The primary outcome was the incidence of pneumothorax in two cohorts within 2 weeks after the procedure. Results In the per-protocol population, pneumothorax rates were 5.9% and 25.7% in the study and control groups, respectively. The difference between the two groups was -19.8% (95% CI: -36.3%, 3.32%) (p = 0.025). On the other hand, in the population with no intraprocedural deviations, pneumothorax rates were 3.2% and 17.2% in the study and control groups, respectively. The difference between the two groups was -14.0% (95% CI: -29.1%, 1.07%) (p = 0.083). In the control group, 3.45% of the cases required aspiration, while no intervention was required in the study group. Conclusion The EPABI application along with IABPI is a promising method to decrease the incidence of pneumothorax following CT-guided percutaneous lung biopsy.