518 - Tract Embolization to Reduce Pneumothorax and Chest Tube Placement After CT-Guided Lung Biopsy: Systematic Review and Meta-Analysis of 10,000+ Patients

Purpose: Pneumothorax is the most common complication of CT-guided percutaneous lung biopsy (PTLB). Tract embolization (TE) has been proposed to reduce this risk. We performed a systematic review and meta-analysis to evaluate the efficacy of TE in preventing pneumothorax and chest tube placement.

Materials and Methods: We conducted a systematic review and meta-analysis registered in PROSPERO (CRD420250616833). PubMed, Embase, Web of Science, and Cochrane were searched until November 2024. Randomized and observational studies reporting TE in PTLB were included. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects models. Number needed to treat (NNT) and exploratory cost analyses were performed.

Results: Twenty-six studies comprising 10,689 patients (5,066 with TE) were included. TE was associated with a lower risk of pneumothorax (RR 0.59; 95% CI 0.54–0.65; p< 0.001; I²=36.9%) compared with no TE, either with blood patch (RR 0.62; 95% CI 0.52–0.73; p< 0.001; I²=49.1%) or gelfoam (RR 0.56; 95% CI 0.49–0.65; p< 0.001; I²=36.2%). TE also reduced chest tube placement (RR 0.47; 95% CI 0.38–0.58; p< 0.001; I²=33.4%), consistent across blood patch (RR 0.46; 95% CI 0.34–0.64; p< 0.001; I²=30.2%) and gelfoam (RR 0.46; 95% CI 0.31–0.68; p< 0.001; I²=47.3%).

Conclusion: Tract embolization after PTLB significantly reduces pneumothorax and chest tube placement, supporting its consideration for broader clinical adoption.