Fig. 1

Real-time, in-plane US-guided pericardiocentesis. A phased-array probe is used to locate the largest pericardial fluid accumulation in the parasternal o para-apical windows a. A high frequency linear probe is used to locate the internal thoracic vessels b, to estimate the distance from the skin to the pericardial sac c and to guide needle trajectory using a real-time in-plane technique, until the needle tip reaches the pericardial sac d, e. Catheter secured to the skin with a standard suture technique f