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Avoiding Vessel Laceration in ThoracentesisA Role of Vascular Ultrasound With Color Doppler: A Role of Vascular Ultrasound With Color Doppler

Mio Kanai, MD; Hiroshi Sekiguchi, MD
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Mayo Foundation for Medical Education and Research, Rochester, MN.

CORRESPONDENCE TO: Hiroshi Sekiguchi, MD, Division of Pulmonary and Critical Care Medicine, Gonda 18 S, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: Sekiguchi.Hiroshi@mayo.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(1):e5-e7. doi:10.1378/chest.14-0814
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Thoracentesis is considered a relatively safe and well-established procedure commonly done at the bedside with minimal risk of complication. Thoracentesis-related hemothorax is uncommon; however, it may be life-threatening. We describe a case of a 19-year-old woman with persistent fever and pleural effusion, in which thoracentesis resulted in tension hemothorax due to intercostal artery laceration. It is important for proceduralists to understand not only the tortuosity of the intercostal artery covering 25% to 50% of the intercostal space, but also the presence of traversing collateral arteries. Herein, we discuss the potential benefit of vascular ultrasonography with color Doppler during thoracentesis, with the goal of avoiding vessel injury and hemorrhage.

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