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