Specially Designed Double-Loop Versus Single-Loop 10.2-Fr Multihole Pigtail Catheters for Pleural Effusion Drainage: A Retrospective Comparative Study of Procedural Efficiency, Catheter Stability, and Safety

초록

OBJECTIVE: To determine whether procedural efficiency, catheter stability, and safety differ between specially designed double-loop (DPC) and single-loop (SPC) 10.2-Fr multihole pigtail catheters for pleural effusion, and to assess the independent association between catheter type and instability. METHODS: This single-center retrospective study (Jan 2024-Aug 2025) analyzed 577 procedures (DPC, n = 299; SPC, n = 278). Inclusion required 10.2-Fr multihole catheters under combined ultrasound-fluoroscopic guidance. Minimal effusions or incomplete records were excluded. Sample size included all eligible procedures without an a priori power calculation. Primary outcomes were catheter retraction and dislodgement. Secondary outcomes included procedure/fluoroscopy time, radiation exposure, success rates, and adverse events. Multivariable logistic regression evaluated the association between catheter type and retraction. RESULTS: DPC showed significantly lower retraction (0.7% [95% confidence interval (CI): 0.1%-2.4%] vs. 16.9% [12.7%-21.8%]; p < 0.001) and dislodgement (0.3% [0.0%-1.8%] vs. 2.9% [1.3%-5.6%]; p = 0.02). On multivariable analysis, DPC was independently associated with lower retraction odds (adjusted odds ratio: 0.034; 95% CI: 0.008-0.141; p < 0.001). DPC significantly reduced procedure time (11.9 vs. 16.3 min), fluoroscopy time (20.4 vs. 43.7 sec), and radiation exposure (4.6 vs. 10.0 mGy) (all p < 0.001). Technical and clinical success rates were 100% in both groups. Overall adverse event rates were low and similar (2.0% vs. 1.8%; p>0.05). CONCLUSIONS: DPC demonstrated lower retraction and dislodgement rates than SPC. Its intrinsic anchoring mechanism simplifies the procedure and obviates the need for skin fixation, while also reducing overall procedure time and radiation exposure. Copyright © 2026. Published by Elsevier Inc.

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