Computed tomography–guided pericardiocentesis: utility in the management of malignant pericardial effusion

: Transthoracic echocardiography is an established means of diagnosing a pericardial effusion and has become the reference guidance modality for drainage of symptomatic collections. However, echocardiographic drainage is not feasible in all patients for a variety of technical and patient-related factors. Computed tomography (CT)-directed pericardiocentesis using a standard Seldinger technique is an alternative means of draining pericardial effusions and overcomes many of the limitations associated with echocardiography. We present a case in which a CT-guided approach was used to successfully drain a malignant pericardial effusion in the emergent setting. Clinicians should be aware of the potential role of CT in this setting.