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Background: Computed tomography (CT)-guided lung biopsy is a widely used technique for the diagnosis of pulmonary lesions and with a high technical success rate and diagnostic accuracy. On the other hand, it is associated with a high risk of complications, especially pneumothorax. Various methods have been tried to reduce the incidence of pneumothorax, but no established method exists. The purpose of this study was to evaluate whether the combination of tract sealing with normal saline and rapid rollover can reduce the rate of pneumothorax and chest tube insertion after CT-guided lung biopsy. Methods: We reviewed all CT-guided lung biopsies performed at a single institution between October 2016 and December 2021. Before August 2019, no specific additional techniques were employed to mitigate complications (Group 1). In contrast, after September 2019, normal saline for tract sealing was injected during needle removal, and if pneumothorax was observed during the intervention, the patient was rolled over into the puncture-site down position immediately after needle removal (Group 2). The rate of complications was compared between the two groups. Results: 130 patients in Group 1 and 173 in Group 2 were evaluated. There was no significant difference in pneumothorax rate between the two groups (30.0% vs. 23.1%, P =.177). A chest tube was inserted in 10 of 130 patients in Group 1 and only in 1 of 173 in Group 2 (P =.001). There were no complications associated with this combinational technique. Conclusions: The combination of normal saline injection and rapid rollover significantly reduced the incidence of pneumothorax requiring chest tube insertion after CT-guided lung biopsy. Therefore, normal saline injection and rapid rollover can serve as a preventive method for severe pneumothorax in CT-guided lung biopsy. [ABSTRACT FROM AUTHOR]

This letter describes four cases of delayed pneumonia around coils after embolization of pulmonary arteriovenous malformations (PAVMs). PAVMs are abnormal direct communications between pulmonary arteries and veins without capillary networks and can lead to severe complications. Coil embolization is a recommended treatment for PAVMs, but long-term complications are rarely reported. In these four cases, patients developed pneumonia around the coils several years after treatment. The exact cause of this complication is unknown, but bacterial infection and non-infectious inflammation are possible factors. Symptoms were relieved with antibiotic and/or hemostatic treatment, and further research is needed to determine the appropriate treatment for this complication. [Extracted from the article]