Abdominal Radiology

, Volume 42, Issue 8, pp 2160–2167 | Cite as

Bending percutaneous drainage catheters to facilitate CT-guided insertion using curved trocar technique

  • Adam S. Young
  • Paul B. ShynEmail author
  • Oren W. Johnson
  • Nisha I. Sainani
  • Richard D. Nawfel
  • Stuart G. Silverman



To assess the safety and efficacy of placing thoraco-abdominal drainage catheters under CT-guidance using a curved trocar technique.


A retrospective study of 182 CT/CT-fluoroscopy-guided thoraco-abdominal catheter drainages was conducted; half were performed by residents or fellows under the supervision of one radiologist (Group 1) and the other half under the supervision of 10 other radiologists (Group 2). Group 1 procedures employed a curved catheter assembly placed using trocar technique (n = 44) or straight catheters placed with Seldinger technique (n = 47). Group 2 procedures employed a straight catheter placed using trocar technique (n = 16) or straight catheters placed with Seldinger technique (n = 75). Technical success, procedure time, radiation dose (CT Dose Index CTDIvol), and adverse events (Common Terminology Criteria for Adverse Events, 4.0) were compared between techniques and groups using Student’s t test, Fisher’s exact test or Chi-square analysis.


All procedures in groups 1 and 2 were technically successful. Mean procedure time for Group 1 curved trocar technique (28 ± 8 min) was shorter than groups 1 and 2 Seldinger technique (37 ± 11 min, p = .00002). Mean CTDIvol for Group 1 curved trocar technique (107.8 ± 54.2 mGy) was lower than groups 1 and 2 Seldinger technique (136.1 ± 99.7 mGy, p = 0.032). Adverse event rates for curved trocar, straight trocar, and Seldinger techniques were 2.3% (1/44), 0% (0/16), and 3.3% (4/122), respectively (p = 1); all were grade 1 or 2, and no catheter malfunctions occurred.


The curved catheter trocar technique is a safe and effective modification of the standard trocar technique that may facilitate CT-guided procedures impeded by CT gantry size limitations.


Catheter drainage CT-guided Trocar Abdominal abscess Pneumothorax 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

Supplementary material

Supplementary material 1 (MOV 25028 kb)


  1. 1.
    Jaffe TA, Nelson RC (2016) Image-guided percutaneous drainage: a review. Abdom Radiol 41:629–636CrossRefGoogle Scholar
  2. 2.
    Duszak RL Jr, Levy JM, Akins EW, et al. (2000) Percutaneous catheter drainage of infected intraabdominal fluid collections. American College of Radiology. ACR Appropriateness Criteria. Radiology 215:1067–1075Google Scholar
  3. 3.
    Maher MM, Gervais DA, Kalra MK, et al. (2004) The inaccessible or undrainable abscess: how to drain it. Radiographics 24:717–735CrossRefPubMedGoogle Scholar
  4. 4.
    McDermott S, Levis DA, Arellano RS (2012) Approaches to the difficult drainage and biopsy. Semin Intervent Radiol 29:256–263CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gervais DA, Brown SD, Connolly SA, et al. (2004) Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics 24:737–754CrossRefPubMedGoogle Scholar
  6. 6.
    Silverman SG, Tuncali K, Adams DF, et al. (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212:673–681CrossRefPubMedGoogle Scholar
  7. 7.
    Nawfel RD, Judy PF, Silverman SG, et al. (2000) Patient and personnel ex- posure during CT fluoroscopy-guided interven- tional procedures. Radiology 216:180–184CrossRefPubMedGoogle Scholar
  8. 8.
    Carlson SK, Bender CE, Classic KL, et al. (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520CrossRefPubMedGoogle Scholar
  9. 9.
    Paulson EK, Sheafor DH, Enterline DS, McAdams HP, Yoshizumi TT (2001) CT fluoroscopy-guided interventional procedures: techniques and radiation dose to radiologists. Radiology 220:161–167Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of RadiologyBrigham and Women’s HospitalBostonUSA

Personalised recommendations