Risk factors for haemoptysis after percutaneous transthoracic needle biopsies in 4,172 cases: Focusing on the effects of enlarged main pulmonary artery diameter.

OBJECTIVES: To evaluate the risk factors for haemoptysis after cone-beam computed tomography (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB), particularly on whether the enlargement of main pulmonary artery diameter (mPAD) is a risk factor for PTNB-related haemoptysis.

METHODS: 4,172 cases of CBCT-guided PTNBs in 3,840 patients were retrospectively included in this study. Various data including mPAD measured on preprocedural CT images were evaluated using logistic regression analyses to determine significant risk factors for both haemoptysis and severe haemoptysis, designated as when blood transfusion, vascular embolisation or cardiopulmonary resuscitation were required to manage patients with haemoptysis.

RESULTS: Haemoptysis occurred in 5.78 % (241/4172) of all PTNB procedures, while severe haemoptysis occurred in 0.18 % (7/4172). Female sex, history of antiplatelet or anticoagulative drugs, prolonged activated partial thromboplastin time, subsolid nodules, cavitary nodules and long pleura-to-target distance were revealed to be independent risk factors for haemoptysis, while mPAD enlargement (> 29.5 mm) was not. Regarding severe haemoptysis, however, mPAD enlargement was demonstrated to be an independent risk factor along with the presence of subsolid and cavitary target nodules.

CONCLUSION: mPAD enlargement was not a significant risk factor for PTNB-related haemoptysis; however, it was a significant risk factor for severe haemoptysis.

KEY POINTS: • mPAD enlargement was a significant risk factor for severe PTNB-related haemoptysis. • mPAD can be useful in screening high-risk patients for severe haemoptysis. • Subsolid or cavitary nodule was another significant risk factor for severe haemoptysis.