Learning objectives
To provide a comprehensive overview of most common vascular and non-vascular thoracic intervention techniques
To recognize specific indications and contraindications for thoracic interventions
Background
Due to the constant improvements and innovations in interventional radiology mostly associated with aortic and peripheral vascular interventions, the thoracic interventions remain somewhat neglected. In spite of that, their role in everyday practice, reducing hospital stay and costs are well established, making them the treatment of choice for certain conditions such as obstruction of superior vena cava, pulmonary arteriovenous malformations and treating pulmonary lesions and fluid collections. Interventions are usually performed under the guidance of ultrasound, computerized tomography (CT), fluoroscopy and, to a lesser extent,...
Findings and procedure details
Non-vascular interventions include transthoracic needle biopsy, thermal ablation of lung malignancies and drainage of thoracic fluid collections.
Thoracic Vascular interventions include stenting of superior vena cava, embolization of arteriovenous malformations, transpulmonary chemoembolization and embolization of bronchial arteries following hemoptysis.
Transthoracic needle biopsy (TTNB)
Indications:
Indeterminate pulmonary or mediastinal nodule or mass, depending on probability of malignancy and presence of metastatic disease.
Distinguishing changes following radiotherapy and surgery from recurrent disease.
Distinguishing infections from malignancies.
Contraindications
All contraindications are relative and do not pose a threat...
Conclusion
Due to the word limit for this type of poster other interesting thoracic interventions such as pTEVAR and pulmonary thrombectomy will not be covered in this review. Transbronchial thoracic interventions, such as biopsy, needle aspiration, cryobiopsy, bronchial stenting, bronchoplasty, foreign body removal, pleurodesis and thermoplasty are beyond the scope of this poster, as they fall within the domain of interventional pulmonology.
It is important for clinicians and radiologists alike to know the indications and contraindications for these procedures. Radiologists should additionally be familiar with the...
Personal information and conflict of interest
L. Filipović-Grčić:
Nothing to disclose
D. Perkov:
Nothing to disclose
I. Jurca:
Nothing to disclose
K. Novacic:
Nothing to disclose
A. M. Alduk:
Nothing to disclose
M. Prutki:
Nothing to disclose
References
Birchard KR. Transthoracic needle biopsy. Semin Intervent Radiol. 2011;28(1):87-97. doi:10.1055/s-0031-1273943
Venturini M, Cariati M, Marra P, Masala S, Pereira PL, Carrafiello G. CIRSE Standards of Practice on Thermal Ablation of Primary and Secondary Lung Tumours. Cardiovasc Intervent Radiol. 2020 May;43(5):667-683. doi: 10.1007/s00270-020-02432-6. Epub 2020 Feb 24. PMID: 32095842.
Lin M, Eiken P, Blackmon S. Image guided thermal ablation in lung cancer treatment [published correction appears in J Thorac Dis. 2021 Jan;13(1):502]. J Thorac Dis. 2020;12(11):7039-7047. doi:10.21037/jtd-2019-cptn-08
Azizi AH, Shafi I, Shah N, Rosenfield K, Schainfeld...