Arteriovenous Fistula and Pseudoaneurysm: Two Important But Rare Complications of Percutaneous Renal Biopsy and Safety of the 16 G Automated Biopsy Needle

Abstract

OBJECTIVE:The aim of this study was to evaluate the safety of 16 G automated biopsy needles, and the incidence of AVF and pseudoaneurysm in patients undergoing renal biopsy. MATERIAL and METHODS:Patients who underwent renal biopsy from January 2010 to December 2012 were prospectively evaluated. Color Doppler USG, hemoglobin and platelet counts, spot urine analysis were performed perormed before and after the biopsy procedure, AVF and pseudoaneurysm that developed secondary to percutaneous renal biopsy were evaluated by Doppler USG at 12 h, and 24 h, and 6 and 12 months after biopsy. RESULTS:Postbiopsy small perirenal, subcapsular, or parenchymal bleeding without clinical relevance were detected in 59 patients (89.2 %) 12 and 24 hours after procedure. RBC counts per high power fi eld increased signifi cantly after the procedure in all subjects (p<0.05). Signifi cant retroperitoneal bleeding, macroscopic hematuria, arteriovenous malformation, and pseudoaneurysm were not detected in our cohort. Glomeruli counts were acceptable in all subjects. CONCLUSION:To optimize safety, patient comfort, and diagnostic yield, a 16 G automated biopsy needle with real-time U/S guidance may be prefered as the standard approach.

Rare but Feared Complications of Percutaneous Renal Biopsy: Arteriovenous Fistula and Pseudoaneurysm

“…tarafından, böbreğin üst ve alt polünden USG eşliğinde 16G iğne ile alınan biyopsilerin güvenli olduğu, kısa ve uzun dönemde AVF ve yalancı anevrizma gelişmeyeceği bildirilse de bizim olgumuzda USG eşliğinde 16G tru-cut iğne ile böbrek alt polden biyopsi alındığı halde vasküler komplikasyon gelişmiştir. 12 USG eşliğinde otomatik biyopsi tabancalarının kullanılması komplikasyon oranını ciddi ölçüde azaltmıştır. 13 Yapılan bir prospektif çalışmada, 14G ve 16G otomatik iğneler arasında komplikasyon insidansı ve alınan glomerül sayısında fark saptanmamıştır.…”