Ultrasound-guided plugged percutaneous biopsy of solid organs in patients with bleeding tendencies

Abstract

Objective: To establish and verify the utility of plugging biopsy tracts, using a combination of Gelfoam slurry and torpedo in the prevention of post-biopsy bleeding in patients at high risk of post-procedure haemorrhage following ultrasoundguided percutaneous biopsy of solid organs. Design: Case series. Setting: Radiology Department of a regional hospital in Hong Kong. Patients: In our unit, all patients considered to be at high risk of post-biopsy haemorrhage of a solid organ underwent ultrasound-guided plugged percutaneous biopsy from year 2005 to 2012. Interventions: All the included patients had undergone real-time ultrasound-guided biopsy of solid organs (liver in 10 and spleen in one patient). In all cases, a combination of a coaxial introducer needle and Temno needle were used. After adequate specimens were obtained, Gelfoam slurry (for distal embolisation) followed by Gelfoam torpedo (for proximal embolisation) were used to plug the biopsy tract. Main outcome measures: Technical success, anypost-biopsy haemorrhage treated by transfusion or other intervention, and plugging-related complications were reviewed for each patient. Results: Technical success was achieved in all patients and none experienced post-biopsy haemorrhage treated by blood transfusion or any other intervention. Conclusion: Plugging of the biopsy tract with Gelfoam slurry followed by Gelfoam torpedo is a direct and simple procedure that can safely and effectively prevent haemorrhage in patients at high risk of post-biopsy haemorrhage.