Alan A Sag1, Lynn A Brody2, Majid Maybody2, Joseph P Erinjeri2, Xiaodong Wang3, Thomas Wimmer4, Mikhail Silk2, Elena N Petre2, Stephen B Solomon2. 1. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Division of Interventional Radiology, Department of Radiology, Koç University School of Medicine, Istanbul, Turkey. Electronic address: asag@ku.edu.tr. 2. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. 3. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Interventional Radiology, Peking University Cancer Hospital and Institute and Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing, China. 4. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Radiology, Medical University of Graz, Graz, Austria.
Abstract
PURPOSE: To report incidence of acute versus delayed presentations of bleeding requiring embolization after focal liver biopsy, in correlation with angiographic findings and treatment success rates. The available literature will be reviewed as well. MATERIALS AND METHODS: Health Insurance Portability and Accountability Act-compliant institutional review board approved retrospective review of 2180 consecutive patients undergoing 2335 targeted liver biopsies at a tertiary-care cancer center. Hepatic arterial embolization episodes within 30days from biopsy were identified via radiology PACS. Electronic medical record review was performed for indication of embolization and postembolization clinical course. RESULTS: The incidence of postbiopsy bleeding requiring embolization was 0.5% (12/2335 biopsies). In those with bleeding, 1/12 (8%) had no hepatic arterial findings at angiography. Angiographic hepatic arterial findings resolved after embolization in 11/11 patients (100% technical success). Bleeding ceased after embolization in 10/12 patients (83% clinical success). Complications were seen in 2/12 (17%) patients: cholecystitis and hepatic infarct, respectively. Delayed presentation of bleeding (defined as >24h postbiopsy) occurred in 5/12 (42%) patients; the longest latency was 12days. CONCLUSION: The overall incidence of bleeding requiring embolization in our population was 0.5%. This complication rate compares favorably to the 0-4.2% (median: 0.29%) rate quoted in the available, heterogeneous, literature on this topic. Delayed presentation occurred in almost half of patients. Arterial embolization carries excellent technical and clinical success rates.
PURPOSE: To report incidence of acute versus delayed presentations of bleeding requiring embolization after focal liver biopsy, in correlation with angiographic findings and treatment success rates. The available literature will be reviewed as well. MATERIALS AND METHODS: Health Insurance Portability and Accountability Act-compliant institutional review board approved retrospective review of 2180 consecutive patients undergoing 2335 targeted liver biopsies at a tertiary-care cancer center. Hepatic arterial embolization episodes within 30days from biopsy were identified via radiology PACS. Electronic medical record review was performed for indication of embolization and postembolization clinical course. RESULTS: The incidence of postbiopsy bleeding requiring embolization was 0.5% (12/2335 biopsies). In those with bleeding, 1/12 (8%) had no hepatic arterial findings at angiography. Angiographic hepatic arterial findings resolved after embolization in 11/11 patients (100% technical success). Bleeding ceased after embolization in 10/12 patients (83% clinical success). Complications were seen in 2/12 (17%) patients: cholecystitis and hepatic infarct, respectively. Delayed presentation of bleeding (defined as >24h postbiopsy) occurred in 5/12 (42%) patients; the longest latency was 12days. CONCLUSION: The overall incidence of bleeding requiring embolization in our population was 0.5%. This complication rate compares favorably to the 0-4.2% (median: 0.29%) rate quoted in the available, heterogeneous, literature on this topic. Delayed presentation occurred in almost half of patients. Arterial embolization carries excellent technical and clinical success rates.
Authors: Birgit Terjung; Isabelle Lemnitzer; Franz Ludwig Dumoulin; Wolfgang Effenberger; Hans Hermann Brackmann; Tilman Sauerbruch; Ulrich Spengler Journal: Digestion Date: 2003 Impact factor: 3.216
Authors: M Zins; V Vilgrain; S Gayno; Y Rolland; L Arrivé; M H Denninger; M P Vullierme; D Najmark; Y Menu; H Nahum Journal: Radiology Date: 1992-09 Impact factor: 11.105