TY - JOUR
T1 - Preoperative short hookwire placement for small pulmonary lesions
T2 - evaluation of technical success and risk factors for initial placement failure
AU - Iguchi, Toshihiro
AU - Hiraki, Takao
AU - Matsui, Yusuke
AU - Fujiwara, Hiroyasu
AU - Masaoka, Yoshihisa
AU - Tanaka, Takashi
AU - Sato, Takuya
AU - Gobara, Hideo
AU - Toyooka, Shinichi
AU - Kanazawa, Susumu
N1 - Funding Information:
Acknowledgements The authors thank Toshiharu Mitsuhashi for his assistance with the statistical analyses. The work was supported by the Center for Innovative Clinical Medicine, Okayama University Hospital.
Publisher Copyright:
© 2017, European Society of Radiology.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Objectives: To retrospectively evaluate the technical success of computed tomography fluoroscopy-guided short hookwire placement before video-assisted thoracoscopic surgery and to identify the risk factors for initial placement failure. Methods: In total, 401 short hookwire placements for 401 lesions (mean diameter 9.3 mm) were reviewed. Technical success was defined as correct positioning of the hookwire. Possible risk factors for initial placement failure (i.e., requirement for placement of an additional hookwire or to abort the attempt) were evaluated using logistic regression analysis for all procedures, and for procedures performed via the conventional route separately. Results: Of the 401 initial placements, 383 were successful and 18 failed. Short hookwires were finally placed for 399 of 401 lesions (99.5%). Univariate logistic regression analyses revealed that in all 401 procedures only the transfissural approach was a significant independent predictor of initial placement failure (odds ratio, OR, 15.326; 95% confidence interval, CI, 5.429–43.267; p < 0.001) and for the 374 procedures performed via the conventional route only lesion size was a significant independent predictor of failure (OR 0.793, 95% CI 0.631–0.996; p = 0.046). Conclusions: The technical success of preoperative short hookwire placement was extremely high. The transfissural approach was a predictor initial placement failure for all procedures and small lesion size was a predictor of initial placement failure for procedures performed via the conventional route. Key points: • Technical success of preoperative short hookwire placement was extremely high. • The transfissural approach was a significant independent predictor of initial placement failure for all procedures. • Small lesion size was a significant independent predictor of initial placement failure for procedures performed via the conventional route.
AB - Objectives: To retrospectively evaluate the technical success of computed tomography fluoroscopy-guided short hookwire placement before video-assisted thoracoscopic surgery and to identify the risk factors for initial placement failure. Methods: In total, 401 short hookwire placements for 401 lesions (mean diameter 9.3 mm) were reviewed. Technical success was defined as correct positioning of the hookwire. Possible risk factors for initial placement failure (i.e., requirement for placement of an additional hookwire or to abort the attempt) were evaluated using logistic regression analysis for all procedures, and for procedures performed via the conventional route separately. Results: Of the 401 initial placements, 383 were successful and 18 failed. Short hookwires were finally placed for 399 of 401 lesions (99.5%). Univariate logistic regression analyses revealed that in all 401 procedures only the transfissural approach was a significant independent predictor of initial placement failure (odds ratio, OR, 15.326; 95% confidence interval, CI, 5.429–43.267; p < 0.001) and for the 374 procedures performed via the conventional route only lesion size was a significant independent predictor of failure (OR 0.793, 95% CI 0.631–0.996; p = 0.046). Conclusions: The technical success of preoperative short hookwire placement was extremely high. The transfissural approach was a predictor initial placement failure for all procedures and small lesion size was a predictor of initial placement failure for procedures performed via the conventional route. Key points: • Technical success of preoperative short hookwire placement was extremely high. • The transfissural approach was a significant independent predictor of initial placement failure for all procedures. • Small lesion size was a significant independent predictor of initial placement failure for procedures performed via the conventional route.
KW - Interventional radiology
KW - Lung
KW - Preoperative localization
KW - Pulmonary nodule
KW - Video-assisted thoracoscopic surgery
UR - http://www.scopus.com/inward/record.url?scp=85038108187&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038108187&partnerID=8YFLogxK
U2 - 10.1007/s00330-017-5176-2
DO - 10.1007/s00330-017-5176-2
M3 - Article
C2 - 29247354
AN - SCOPUS:85038108187
SN - 0938-7994
VL - 28
SP - 2194
EP - 2202
JO - European Radiology
JF - European Radiology
IS - 5
ER -