Objective  To introduced the thread-hanging-assisted microwave antenna method for puncturing small malignant pulmonary nodules percutaneously and compared it with the freehand procedure, evaluating its clinical application value.

  Methods  A total of 94 cases with solitary malignant pulmonary nodules were enrolled in The Fourth Hospital of Hebei Medical University. The mean length of CT axial position of pulmonary nodules was (10.2±1.3) mm. There were 45 cases with solid pulmonary nodules, 38 with mixed ground-glass nodules, and 11 with pure ground-glass nodules. The pleura-to-pulmonary nodule distance was <1 cm in 20 cases, 1–5cm in 43 cases, and >5cm in 31 cases. These cases were randomly assigned into 2 groups, the control group, including pulmonary nodules managed with CT-guided percutaneous freehand puncture with a microwave antenna, and the test group, including pulmonary nodules managed with thread-hanging assisted microwave antennae puncture method. If the needle tip was withdrawn or inserted into the periphery of the pulmonary nodule, the puncture was deemed to have failed; otherwise, it was considered successful. The success rate and complications of the puncture before ablation were recorded separately in the two groups.

  Results  The success rate of antenna puncture was 91.3% in the test group and 71.7% in the control group (P<0.01). The pulmonary hemorrhage rate was 13.0% in the test group and 21.7% in the control group (P<0.05). The pneumothorax rate was 15.2% in the test group and 17.4% in the control group (P>0.05).

  Conclusions  The thread-hanging method can improve the success rate of percutaneous puncture of malignant pulmonary nodules. This method is simple, safe, effective and inexpensive; therefore, it merits further evaluation.