Fibrin sealant as a plug for the post liver biopsy needle track

Chisholm, Reginald; Jones, Susan; Lees, WR

doi:10.1016/s0009-9260(89)80326-5

Cited by 32 publications

(10 citation statements)

References 7 publications

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“…This application of RF ablation may offer a method for prevention of hemorrhage after biopsy, particularly in clinical settings in which the patient may be at greater risk. RF ablation of the needle tract offers advantages over alternative embolic or prothrombotic approaches to treat hemorrhage described in the literature in that it eliminates the risk of vascular embolization and avoids placement of implants (4)(5)(6)(7)(8)(9)(10). Cauterization of the needle tract may also reduce the incidence of seeding by malignant cells.…”

Section: Discussionmentioning

confidence: 99%

“…If the operator notices a large amount of blood emitting from a biopsy needle or if a particular tumor is deemed to be at high risk for hemorrhage, there are few options for the operator. Several potential approaches have been reported in the literature, including transneedle placement of steel coils (4) and injection of fibrin (5), gelatin particles and thrombin (6), gelatin sponge pledgets (7,8), fibrinogen and thrombin (9,10), or autologous blood clot in an attempt to promote clotting and hemostasis in the needle tract. Kim et al (11) reported animal studies of radiofrequency (RF) coagulation with use of the biopsy needle itself to deliver the RF energy.…”

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confidence: 99%

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Radiofrequency Cauterization with Biopsy Introducer Needle

Pritchard

Wray‐Cahen

Karanian

et al. 2004

Journal of Vascular and Interventional Radiology

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PURPOSE-The principal risks of needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. This study compared hemorrhage after liver and kidney biopsy with and without radiofrequency (RF) ablation of the needle tract.MATERIALS AND METHODS-Biopsies of liver and kidney were performed in swine through introducer needles modified to allow RF ablation with the distal 2 cm of the needle. After each biopsy, randomization determined whether the site was to undergo RF ablation during withdrawal of the introducer needle. Temperature was measured with a thermistor stylet near the needle tip, with a target temperature of 70°C-100°C with RF ablation. Blood loss was measured as grams of blood absorbed in gauze at the puncture site for 2 minutes after needle withdrawal. Selected specimens were cut for gross examination.RESULTS-RF ablation reduced bleeding compared with absence of RF ablation in liver and kidney (P < .01), with mean blood loss reduced 63% and 97%, respectively. Mean amounts of blood loss (±SD) in the liver in the RF and no-RF groups were 2.03 g ± 4.03 (CI, 0.53-3.54 g) and 5.50 g ± 5.58 (CI,.66 g), respectively. Mean amounts of blood loss in the kidney in the RF and no-RF groups were 0.26 g ± 0.32 (CI, −0.01 to 0.53 g) and 8.79 g ± 7.72 (CI, 2.34-15.24 g), respectively. With RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed.CONCLUSION-RF ablation of needle biopsy tracts reduced hemorrhage after biopsy in the liver and kidney and may reduce complications of hemorrhage as well as implantation of tumor cells in the tract.PERCUTANEOUS image-guided needle biopsy is often performed in highly vascular organs or in tumors with rich macroscopic and microscopic blood supply. The principal risks related to needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. Incidences of postbiopsy hematoma in the liver have been reported in prospective studies to be 18.3% after biopsy with a 2.0-mm Tru-cut needle (1) and 23% after biopsy with a 1.6-mm Jamshidi needle (2). Patients with cirrhosis or hepatic tumors are at greater (4) and injection of fibrin (5), gelatin particles and thrombin (6), gelatin sponge pledgets (7,8), fibrinogen and thrombin (9,10), or autologous blood clot in an attempt to promote clotting and hemostasis in the needle tract. Kim et al (11) reported animal studies of radiofrequency (RF) coagulation with use of the biopsy needle itself to deliver the RF energy.Transplantation of tumor cells along the needle tract after biopsy of a malignancy is also a risk. Incidences of needle tract implantation after biopsy of hepatocellular carcinoma have been reported in two recent series as 3.9% (12) and 5.1% (13). There are also published reports of subcutaneous seeding after fine needle biopsy of metastatic colonic adenocarcinoma (14,15) and metastatic pancreatic adenocarcinoma (16). The development of an effective, inexpensive, and technically simple method of cauterizing a coaxial needle biopsy tract could provide a soluti...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Radiofrequency Cauterization with Biopsy Introducer Needle

Pritchard

Wray‐Cahen

Karanian

et al. 2004

Journal of Vascular and Interventional Radiology

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“…However, there have been no well-documented reports on the effectiveness of fibrin glue in sealing the track following LB and no reports following PLB [3].…”

Section: Discussionmentioning

confidence: 99%

“…McCartney et al [11,12] were the first to introduce the use of homologous blood in lung biopsies to prevent pneumothorax, while Chuang et al [4] used Gelfoam in liver biopsies to reduce hemorrhage in high-risk patients. Over the past decade fibrin glue has proven a very effective sealing material with a wide variety of applications [3,9,10,15,17]. We have previously reported our experience with the use of homologous blood as a tamponade material [13].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Needle Biopsy: Fibrin Glue to Prevent Complications

Petsas¹,

Dougenis²,

Giannakenas³

et al. 1995

Fibrin Sealing in Surgical and Nonsurgical Fields

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We examined the efficacy of fibrin glue in eliminating complications following percutaneous needle biopsy. Lung biopsy was performed in ten rabbits and liver biopsy in five, using a coaxial needle system. Fibrin glue mixed with 1311_ labeled fibrinogen and contrast medium was used to embolize the needle track. Scintigraphy showed that radionuclide accumulation at the injection site decreased gradually, while apart from the thyroid gland there was no other site of isotope uptake. Computed tomography showed no contrast medium at the biopsy site 12-48 h after the procedure. Microscopic examination showed fibrin glue as a fibrin network filling alveoli and part of the needle tract. Similar findings were observed in the liver. We also used this method in 26 high-risk patients with suspected malignancy. Percutaneous lung biopsy was performed in eight patients with severe chronic obstructive lung disease and six with emphysematous bullae, while nine with prothrombin time higher than 18 sand three with liver hemangioma underwent liver biopsy. There were only two minor pneumothoraces in the lung biopsy group and no complications in the liver group. We conclude that this method is an effective and safe tamponade procedure, associated with a very low complication rate. We recommend it as particularly suitable in high-risk patients undergoing lung or liver needle biopsy.

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“…Various techniques have been used in the past for promoting blood clotting after percutaneous needle biopsies. These approaches involve trans-needle placement of steel coils (Allison and Adam 1988) and injection of fibrin (Chisholm et al 1989), gelatin particles and thrombin (Zins et al 1992), gelatin sponge pledgets (Smith et al 1996;Fandrich et al 1996), and fibrinogen and thrombin (Falstrom et al 1999;Paulson et al 2000). These techniques do not provide a solution to the possibility of tumor cell deposition along the needle tract (Pritchard et al 2004).…”

Section: Introductionmentioning

confidence: 99%

A biopsy tool with integrated piezoceramic elements for needle tract cauterization and cauterization monitoring

Visvanathan

Gianchandani

2011

Biomed Microdevices

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This paper reports the feasibility of biopsy needle tract cauterization and cauterization monitoring using an embedded array of piezoceramic microheaters. Circular heaters of lead zirconate titanate (PZT-5A), with 200 μm diameter and 70-80 μm thickness, are fabricated using a batch mode micro ultrasonic machining process. These are then assembled into cavities in the walls of 20-gauge stainless steel needles and sealed with epoxy. Experiments are performed by inserting the proposed biopsy needle into porcine tissue samples. The needle surface exceeds the minimum target temperature rise of 33°C for either radial or thickness mode vibrations. The corresponding input power levels are 236 mW and 325 mW, respectively. The tissue cauterization extends 1-1.25 mm beyond the perimeter of the needle and is uniform in all directions. After cauterization, the fundamental anti-resonance frequency and the corresponding impedance magnitude of the PZT heater decrease by 4.1% and 42.6%, respectively, thereby providing a method to monitor the extent of tissue cauterization. A sensing interface circuit capable of measuring the resonance frequency shift of the PZT elements is built and tested using discrete integrated circuit components. The circuit detects the resonance frequency shift from 8.22 MHz to 7.96 MHz of the PZT elements when the biopsy needle is inserted into wax medium. An interface circuit for actuation of the PZT elements for tissue cauterization is also described.

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Fibrin sealant as a plug for the post liver biopsy needle track

Cited by 32 publications

References 7 publications

Radiofrequency Cauterization with Biopsy Introducer Needle

Radiofrequency Cauterization with Biopsy Introducer Needle

Percutaneous Needle Biopsy: Fibrin Glue to Prevent Complications

A biopsy tool with integrated piezoceramic elements for needle tract cauterization and cauterization monitoring

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