An Unexpected Complication of Bone Marrow Aspiration and Trephine Biopsy: Arteriovenous Fistula

Berber, İlhami; Erkurt, Mehmet Ali; Kuku, İrfan; Kaya, Emin; Kutlu, Ramazan; Köroğlu, Mustafa; Yiğit, Ali; Ünlü, Serkan

doi:10.1159/000358173

Cited by 23 publications

(18 citation statements)

References 8 publications

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“…Ilhami et al . reported an unexpected complication of bone marrow biopsy of an arteriovenous fistula secondary to injury of the superior gluteal artery, for which successful embolization was achieved with coils [3]. Chamisa reported a fatal retroperitoneal hemorrhage caused by damage to the superior gluteal artery.…”

Section: Discussionmentioning

confidence: 99%

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Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report

Zahrani

Peck

2016

J Med Case Reports

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BackgroundIatrogenic arterial injury during bone marrow biopsy is an extremely rare complication. We present unreported complication of median sacral artery injury that was managed successfully with endovascular treatment.Case presentationA 22-year-old Caucasian man known to have end-stage renal disease secondary to Senior-Loken syndrome presented with anemia. He underwent an investigation with bone marrow biopsy that was complicated by hypotension and a further significant drop in his hemoglobin level. Cross-sectional imaging with computed tomography demonstrated a large abdominopelvic retroperitoneal hematoma and active bleeding of the median sacral artery. A successful lifesaving endovascular trans-arterial embolization was performed on an emergency basis and our patient was discharged in a stable condition a few days later.ConclusionIatrogenic arterial injury after a bone marrow biopsy is extremely rare. To the best of our knowledge, a median sacral artery injury has not been previously reported. Endovascular trans-arterial embolization is a safe, effective, and minimally invasive therapeutic option.

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Section: Discussionmentioning

confidence: 99%

“…[2]74 femaleIliolumbar arterySurgeryCompletely recoveredIlhami et al . [3]76 maleSuperior gluteal arteryTranscatheter embolizationCompletely recoveredChamisa [4]29 maleSuperior gluteal arteryTranscatheter embolizationDiedSullivan et al . [5]55 maleSuperior gluteal arteryTranscatheter embolizationCompletely recoveredNeese et al .…”

Section: Introductionmentioning

confidence: 99%

Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report

Zahrani

Peck

2016

J Med Case Reports

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“…Both patients recovered without sequelae. Berber et al 11 detected arteriovenous fistula (AVF) in a 76-year-old man after bone marrow aspiration and biopsy. They suggested that in cases with refractory bleeding AVF should be considered.…”

Section: Discussionmentioning

confidence: 99%

Bone marrow aspiration complications: Iliopsoas abscess and sacroiliac osteomyelitis

et al. 2016

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“…It is generally considered a safe procedure with minimal risks. However, numerous cases of neurovascular injury, including post procedure hemorrhage, arteriovenous fistula formation, gluteal compartment syndrome, and pseudoaneurysm formation have been reported . Retroperitoneal hemorrhage is presumed to occur due to penetration of the biopsy needle through the inner ilial cortex and into adjacent vasculature.…”

Section: Introductionmentioning

confidence: 99%

Safe and successful bone marrow biopsy: An anatomical and CT‐based cadaver study

et al. 2014

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Bone marrow biopsy is generally a safe procedure. However, infrequently the procedure is associated with serious injuries that are attributed to inadvertent needle penetration of the iliac bone's inner cortex. An evidence-based approach to needle orientation during iliac crest biopsy does not exist. In our study, the posterior to anterior path of the bone marrow needle from the posterior superior iliac spine (PSIS) was studied in human cadavers in two orientations: (1) perpendicularly to the coronal plane (the perpendicular approach) and (2) laterally toward the ipsilateral anterior superior iliac spine (ASIS) (the lateral approach). The biopsy needle was deliberately advanced through the inner ilial cortex in both approaches. Dissections and imaging studies were done to identify the relationship of the penetrating needle to internal structures. Both approaches begin with a perpendicular puncture of the outer cortex at the PSIS. The perpendicular approach proceeds anteriorly whereas in the lateral approach the needle is reoriented toward the ipsilateral ASIS before advancing. The lateral approach caused less damage to neurovascular structures and avoided the sacroiliac joint compared to the perpendicular approach. This procedure is best done in the lateral decubitus position. Proper use of the lateral approach should obviate many of the complications reported in the literature.

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An Unexpected Complication of Bone Marrow Aspiration and Trephine Biopsy: Arteriovenous Fistula

Cited by 23 publications

References 8 publications

Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report

Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report

Bone marrow aspiration complications: Iliopsoas abscess and sacroiliac osteomyelitis

Safe and successful bone marrow biopsy: An anatomical and CT‐based cadaver study

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