Percutaneous Lung Biopsies: Pleural & Parenchymal Blood Patching

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.