Risk factors concerning sternal bone marrow aspiration and patient safety in Japan

Abstract

Objective Several reports have described adverse events resulting from sternal bone marrow aspiration procedures. We hypothesized about inevitable lacerations to the ascending aorta that occur from structural abnormalities in the needle passage.Methods We evaluated dimensions in the thorax related to the sternal bone marrow aspiration, using a chest CT scan on a display terminal.Patients Among the 3,848 patients who visited our institution and underwent a chest CT scan between September 1, 2007 and December 31, 2008, a total of 153 subjects showing no particular chest CT findings were enrolled.Results Significant variation was observed in the distance from the sternum to the ascending aorta, from a minimum of 4.2 to a maximum of 47.6 mm (median 23.6) in men and a minimum of 5.2 to a maximum of 38.4 mm (median 21.3) in women. There were three men (3.6%) and women (4.3%) each having a distance within 10 mm.Conclusion Our findings showed for the first time that an anterior chest approach to sternal bone marrow aspiration involves an inevitable risk of laceration of the ascending aorta, when the needle tip penetrates the sternum. Our analysis of dimension also suggested that the sternal marrow aspiration procedure involved a greater risk among older subjects of short stature. © 2010 The Japanese Society of Internal Medicine.