Acute and delayed bleeding requiring embolization after image-guided liver biopsy in patients with cancer.

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.

journal_name

Clin Imaging

journal_title

Clinical imaging

authors

Sag AA,Brody LA,Maybody M,Erinjeri JP,Wang X,Wimmer T,Silk M,Petre EN,Solomon SB

doi

10.1016/j.clinimag.2015.11.004

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

535-40

issue

3

eissn

0899-7071

issn

1873-4499

pii

S0899-7071(15)00286-7

journal_volume

40

pub_type

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