Computed Tomography-Guided Pericardiocentesis: A Practical Guide

Curr Cardiol Rep. 2023 Nov;25(11):1433-1441. doi: 10.1007/s11886-023-01965-9. Epub 2023 Oct 19.

Abstract

Purpose of review: The purpose of this article is to serve as a practical guide to computed tomography (CT)-guided pericardiocentesis and to discuss the role of this approach in current clinical practice. An overview of indications, technique, advantages, and limitations specific to CT-guided pericardiocentesis will be provided. The reader will have an enhanced understanding of the use of this imaging modality to guide pericardial drainage.

Recent findings: Use of CT guidance to drain the pericardial space is safe, especially when adequate echocardiographic evaluation is precluded and when echocardiography-guided pericardiocentesis is deemed unsafe and or not feasible. Our review and experience indicate that CT-guided pericardiocentesis is technically successful in more than 94% of patients, with a low risk (<1%) of significant complications. CT-guided pericardiocentesis is therefore a viable alternative when echocardiographic guidance is insufficient and can obviate the need for surgery in most patients.

Keywords: CT-guided procedure; Computed tomography–guided drainage; Pericardial drainage; Pericardial effusion; Pericardiocentesis; Pneumopericardium.

Publication types

  • Review

MeSH terms

  • Drainage
  • Echocardiography
  • Humans
  • Pericardial Effusion* / diagnostic imaging
  • Pericardial Effusion* / surgery
  • Pericardiocentesis* / adverse effects
  • Pericardiocentesis* / methods
  • Tomography, X-Ray Computed