ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2022
vol. 87
 
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Interventional radiology
abstract:
Original paper

An initial experience of computed tomography-guided trans superior vena caval biopsy: a novel approach for precarious mediastinal lesions

Muthusubramanian Rajasekaran
1
,
Salil Pandey
1
,
Suresh Ashwathappa
1
,
Ganesh Subramanya Mandakulutur
2
,
Shashidhar V Karpurmath
3
,
Manjunath Irappa Nandennavar
3

1.
Department of Radiology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
2.
Department of Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
3.
Department of Medical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
Pol J Radiol 2022; 87: e233-e237
Online publish date: 2022/04/25
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Purpose
As interventional radiologists, we encounter precarious deep-seated mediastinal lesions in our day-to-day practice. The conventional technique of percutaneous transthoracic biopsy of these lesions carries significant intrinsic complications. Endovascular approaches for such lesions under fluoroscopic guidance have been described in previousliterature but with significant technical constraints. In this article, we would like to describe the novel approach of computed tomography (CT)-guided trans superior vena caval biopsy, which we have performed in 3 consecutive precarious mediastinal lesions.

Material and methods
We placed a vascular sheath under ultrasound and fluoroscopic guidance considering the intended angle of needle puncture and length to reach the target lesion from the puncture site. With the sheath in situ, the trans superior vena caval biopsy was performed under CT guidance, and multiple cores of target tissue were safely and successfully obtained.

Results
We have carefully and successfully employed this novel technique of CT-guided trans superior vena caval approach for 3 tricky deep-seated mediastinal lesions with very low risk of complications.

Conclusions
Through this article, we would like to enhance the importance of thought-provoking new techniques in tackling complex challenging referrals.

keywords:

CT-guided, trans caval, biopsy, mediastinal mass




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