Ep. 157 Lung Biopsies Part II: Pleural and Parenchymal Blood Patching with Dr. Fred Lee

In Part II of our Lung Biopsy Series Dr. Fred Lee and Dr. Christopher Beck discuss Pleural and Parenchymal Blood Patching to prevent Pneumothorax, including results of the recent JVIR article from Sept 2021.

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SHOW NOTES

In this episode, Dr. Fred Lee and our host Dr. Chris Beck discuss the use of parenchymal and pleural blood patches to reduce the rate of lung biopsy re-interventions.

First, Dr. Lee describes why he has incorporated parenchymal blood patching at the end of most biopsies, noting that it is a straightforward procedure that only adds on a few extra minutes to the overall biopsy, and it can reduce the rate of re-intervention. Both doctors agree that minimizing the need for chest tubes can greatly improve the patient experience.

Pleural blood patches are used as a salvage technique in the event of a pneumothorax. Dr. Lee walks through his process of re-inflating the lung, finishing the biopsy, and using a three-way stopcock to inject blood onto the pleural surface and along the needle track. He notes that there are other valid ways of treating intraprocedural pneumothoraces (saline, fibrin plug, etc); however, he prefers the pleural blood patch because of its liquid-to-solid clotting transition, minimal time, minimal cost, and relatively low risk.

Throughout this episode, we cite data from Dr. Lee’s previous publications, which are cited below.

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RESOURCES

Percutaneous Lung Biopsy with Pleural and Parenchymal Blood Patching: Results and Complications from 1,112 Core Biopsies:

https://www.jvir.org/article/S1051-0443(21)01202-1/fulltext

CT-Guided Lung Biopsies: Pleural Blood Patching Reduces the Rate of Chest Tube Placement for Postbiopsy Pneumothorax: www.ajronline.org/doi/full/10.2214/AJR.10.6324

Pulmonary Intraparenchymal Blood Patching Decreases the Rate of Pneumothorax-Related Complications following Percutaneous CT–Guided Needle Biopsy: www.jvir.org/article/S1051-0443…6)32178-9/fulltext