PAIR (puncture-aspiration-injection-reaspiration)

The PAIR (puncture-aspiration-injection-reaspiration; sometimes percutaneous aspiration-injection-reaspiration[1]) procedure is a noninvasive treatment option to remove hydatid cysts.[2] PAIR is considered an alternative treatment for cystic echinococcosis (hydatid disease) and is often indicated for patients who do not respond to surgery or benzimidazoles[3]

The PAIR procedure can be performed as follows:[4]

  1. ultrasound-guided percutaneous puncture of the cyst
  2. aspiration of cystic fluid
  3. injection of a scolicidal solution
  4. reaspiration of the solution

References
  1. Smego, Raymond A.; Bhatti, Sabha; Khaliq, Amir A.; Beg, M. Asim (2003-10-15). "Percutaneous Aspiration-Injection-Reaspiration Drainage Plus Albendazole or Mebendazole for Hepatic Cystic Echinococcosis: A Meta-analysis". Clinical Infectious Diseases. 37 (8): 1073–1083. doi:10.1086/378275. ISSN 1058-4838. PMID 14523772.
  2. Filice, C; Pirola, F; Brunetti, E; Dughetti, S; Strosselli, M; Foglieni, CS (May 1990). "A new therapeutic approach for hydatid liver cysts. Aspiration and alcohol injection under sonographic guidance". Gastroenterology. 98 (5 Pt 1): 1366–8. doi:10.1016/0016-5085(90)90358-8. PMID 2182372.
  3. Brunetti, E; Kern, P; Vuitton, DA; Writing Panel for the, WHO-IWGE (Apr 2010). "Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans". Acta Tropica. 114 (1): 1–16. doi:10.1016/j.actatropica.2009.11.001. PMID 19931502.
  4. Golemanov, B.; Grigorov, N.; Mitova, R.; Genov, J.; Vuchev, D.; Tamarozzi, F.; Brunetti, E. (6 January 2011). "Efficacy and Safety of PAIR for Cystic Echinococcosis: Experience on a Large Series of Patients from Bulgaria". American Journal of Tropical Medicine and Hygiene. 84 (1): 48–51. doi:10.4269/ajtmh.2011.10-0312. PMC 3005516. PMID 21212200.
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