Ultrathin Endoscopy-Guided Pericardiocentesis: A Pilot Study in a Swine Model

Kenji Nakatsuma, Erika Yamamoto, Shin Watanabe, Bingyuan Bao, Hiroki Watanabe, Yoshiaki Kawase, Satoshi Shizuta, Takeshi Kimura, Naritatsu Saito

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


BACKGROUND: Pericardiocentesis under echocardiography guidance is a common procedure, but still poses a risk of injury to surrounding tissues. Nowadays, pericardiocentesis is being performed in patients with normal pericardium, for epicardial ablation or atrial appendage exclusion. Access to the normal pericardial space with the conventional needle procedure is very difficult. Thus, development of a novel method enabling safer pericardiocentesis is necessary. The present study aimed to assess the feasibility of using an originally developed ultrathin endoscopy-guided pericardiocentesis device in a swine model. METHODS AND RESULTS: We developed a novel ultrathin endoscopy-guided pericardiocentesis device. The device comprised a 1.2 mm ultrathin endoscope, a 20 G needle, and a grasping forceps. Pericardiocentesis was conducted as follows. A 12 Fr introducer sheath was inserted between the pericardium and the diaphragm under fluoroscopy. The pericardium was grasped with the originally developed forceps under endoscopy guidance to create a space in the pericardial sac. The 20 G needle was then inserted and a coiled-tip guidewire was placed into the pericardial sac. Five independent operators performed pericardiocentesis twice using this technique in a healthy pig with a body weight of approximately 25 kg. Procedural success rate and procedure time were assessed as the primary endpoints. The procedural success rate was 100% in all operators. The average procedure time was 65 ± 40 seconds (median, 46 seconds; interquartile range, 40-85 seconds). No procedure-related complications were noted. CONCLUSIONS: The study results indicate that ultrathin endoscopy-guided pericardiocentesis for normal pericardial space is feasible and safe.

Original languageEnglish
Pages (from-to)78-80
Number of pages3
JournalJournal of Invasive Cardiology
Issue number3
StatePublished - Mar 2016
Externally publishedYes


  • endoscope
  • pericardiocentesis


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