ArticleEcho research and practice2025
Complication rates in real-time ultrasound-guided vs static echocardiography-guided pericardiocentesis: a cohort study.
Article in Echo research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Long-term mortality and acute complications after percutaneous pericardiocentesis in cancer and noncancer patients presenting with severe pericardial effusion.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
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8 authors.
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Abstract
backgroundStatic echocardiography-guided pericardiocentesis, the current standard of care, uses a phased-array probe to locate the largest fluid pocket, marking the safest entry site and needle trajectory. Nevertheless, real-time needle visualization throughout the procedure would potentially increase success and decrease complications. The aim of this study was to assess the complication rates of the real-time in-plane ultrasound-guided technique compared to the traditional static echocardiography-guided pericardiocentesis.
methodsAll adult patients who underwent pericardiocentesis in a tertiary care hospital from January 2011 to June 2024 were identified. The incidence of total complications of the real-time, in-plane, US-guided pericardiocentesis versus the static echocardiography-guided technique was compared using a regression model with overlap weighting, based on propensity scores, to adjust for confounding factors.
resultsA total of 220 pericardiocentesis were identified, 91 with real-time, in-plane US-guided technique and 129 with a static echo-guided approach. The overall rate of total complications was 5.5%, with no significant difference between both techniques (IRR 1.06 [95% CI 0.98 to 1.16, p = 0.163]). Only one major complication was reported with the in-plane technique (pulmonary edema) compared to four major complications in the echo-assisted approach (three cardiac injuries and one injury to thoracic vessels), all of which required emergency surgery. The success rate was higher in the real-time in-plane US-guided procedures (97%) compared to the static echo-guided approach (93%).
conclusionsIn this single-center retrospective cohort study, real-time in-plane, US-guided pericardiocentesis technique was safe, and the rate of total complications was not significantly different from a static echo-guided approach. The low rate of major complications and high success rate underscores the potential use of this technique in emergency situations by well-trained physicians. Future studies are warranted to thoroughly assess the potential benefits of the real-time approach.
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