Lungs
CT-guided biopsies, drainage and embolization for lung and airway conditions — precise, minimally invasive.
OVERVIEW
Dr Marios Agathangelou performs pulmonary interventions in Nicosia and Limassol, Cyprus — covered by GESY, €0 for GESY beneficiaries. Pulmonary interventions reach the lungs and airways through image guidance rather than surgery: CT-guided biopsies sample small lesions for rapid diagnosis, drains clear pleural fluid and abscesses, and embolization controls bleeding (hemoptysis) or closes arteriovenous malformations.
Image guidance supports precision and safety at every step, with typically lower complication rates and shorter hospital stays than surgical alternatives.
WHO IT’S FOR
- A lung lesion that needs a tissue diagnosis
- Pleural fluid or an abscess needing drainage
- Hemoptysis or a pulmonary vascular malformation
PROCEDURES OFFERED
- CT-guided lung biopsy for diagnosis
- Pleural drainage and pleurodesis
- Lung abscess drainage
- Pulmonary artery embolization
- Bronchial artery embolization for hemoptysis
- Treatment of pulmonary arteriovenous malformations
BENEFITS
GESY COVER
The procedure is fully covered by GESY. It is done as an inpatient admission, and that admission includes the treatment — you pay nothing for the procedure.
Separately, the outpatient visit — the initial assessment, where it is decided whether the treatment suits you — may carry a small co-payment, usually €0–10, as any specialist visit within GESY does.
The co-payment is per activity, and it stops once your total co-payments for the year reach €150 — past that you pay nothing. Some categories of beneficiary have different limits.
Both need a valid referral, from your personal doctor or from a specialist.
Outside GESY, or with private insurance? We provide the documentation your insurer asks for, and a clear cost estimate at your consultation, before you decide anything.
BIOPSY, WITH ITS NUMBERS
CT-guided lung biopsy gives a diagnosis in the great majority of cases, which is why it is done: a clear answer changes everything that follows.
It has one specific complication you should know beforehand, not afterwards. In roughly one patient in four, air enters the space around the lung (a pneumothorax). Most are small and settle on their own; about one in fifteen needs a drain and a stay in hospital. Technique and body position affect the risk, and both are taken into account. These are figures from the published literature, not from this practice's own series.
RISKS
Most people feel no more than a sense of pressure where the needle went in: a few hours of observation and home.
After the pneumothorax, the second most frequent complication of the biopsy is bleeding along the needle's track: in a systematic review it affected about seven patients in 100. It usually shows as a little blood in the sputum and stops by itself.
Once in 559. That was the frequency, in one published series, with which air entered the arterial circulation and caused symptoms. It is the complication we fear most and meet least; it is treatable from the moment it is recognised, which is why the hours of observation after the sample are not time wasted.
Emphysema on the path the needle will take carries more weight than advanced age. With it count the size and the depth of the lesion, where it sits in the lung, and the position of the body at the moment the sample is taken. All of it is settled beforehand, on the CT.
Bronchial artery embolization carries a serious risk of its own. A vessel that supplies the spinal cord can arise from that same bronchial artery; this is why the vessels are mapped before anything is injected.
How often it happens we do not know precisely: published rates differ substantially between centres, and one twenty-year London series recorded strokes more often than its own authors expected. That the literature does not agree is itself part of what you are told.
What most often goes wrong is not a complication; it is recurrence. In that same series the haemoptysis came back after 65 of 141 procedures — nearly half — and twenty patients needed a second embolization. The embolization can be repeated, and that is part of the plan rather than a failure of it.
And a clarification about the biopsy: when it gives no answer, that does not mean there is nothing there. It means the sample was not adequate, and the lesion still needs following up or sampling again.
None of these procedures is compulsory and none is decided in a corridor. You will see your own CT, hear what the biopsy result changes and what it does not, and then you decide.
COMMON QUESTIONS
Dr Marios Agathangelou, an interventional radiologist, performs CT-guided lung biopsies, pleural drainage and bleeding control in Nicosia and Limassol. It is covered by GESY — €0 for GESY beneficiaries.
In the published literature, roughly one patient in four has some air around the lung afterwards. Most are small and settle on their own; about one in fifteen needs a drain.
Because a clear diagnosis changes what happens next, and guessing does not. The risk is real and usually small; the value of knowing is usually larger.
Yes, with local anaesthesia and sedation if needed. You will be asked to hold your breath briefly at the moment the sample is taken.
You are observed for a few hours with a check X-ray. If a pneumothorax needs a drain, that means staying in hospital.
To stop coughing up blood when it is significant. It controls the bleeding; the underlying cause still needs treating, and bleeding can recur.
It happens in a minority of cases. Then we discuss repeating it, sampling differently, or another route entirely — with the team looking after you.
Nothing, if you are a GESY beneficiary. GESY covers the procedure in full: it is done as an inpatient admission, and that admission includes the treatment. The outpatient visit where it is decided whether the treatment suits you may carry the usual small GESY co-payment, and you need a valid referral from your personal doctor or from a specialist. Outside GESY, or with private insurance, you get a clear cost estimate at your consultation, before you decide anything.
SOURCES
Complication figures on this page are pooled results from published systematic reviews and series of CT-guided lung biopsy and of bronchial artery embolization — among them a systematic review of biopsy approaches, a series that screened for systemic air embolism with a CT of the whole chest, and a twenty-year single-centre embolization series — not this practice's own series. They describe the procedure in general; they are not advice about your case.