Major complications and deaths due to interventional ultrasonography: A Review of 8000 cases

Abstract

Complications related to approximately 8000 ultrasound-guided punctures performed in our institution during the last 19 years are reported. This study includes 3500 fine needle biopsies, 700 large bore needle biopsies, 2800 punctures of fluid collections using either a 1.2-mm spinal needle or a 7.5 F pigtail catheter, and 1000 percutaneous nephrostomies. The majority were abdominal punctures. The complication rate was 0.187% (0.100% to 0.313%) and the mortality rate 0.038% (0.013% to 0.113%). Using the fine needle data exclusively, these rates were 0.200% (0.086% to 0.400%) and 0.028% (0.000% to 0.171%), respectively. The 95% confidence limits are in brackets.

Sonography Guided Percutaneous Nephrostomy: Success Rates According to the Grade of the Hydronephrosis

“…In our series, there were two perirenal hematoma and one postprocedure sepsis and this % 5 incidance of significant complications are not significantly higher than fluoroscopy guided procedures. There were eight (% 13.7) catheter dislodgement and two (% 3.4) catheter blockages that required exchange of catheter in our series and these rates are in correlation with reported %7-14 minor complication rates of fluoroscopy guided procedures (2,17,18). …”

Seeding after ultrasound-guided percutaneous biopsy of liver metastases in patients with colorectal or breast cancer

“…The purpose of this study was to estimate frequency of underexposed in the literature implantation seeding after percutaneous liver biopsy and whether this complication affected outcome. Other potential complications after liver biopsy, such as pain, bleeding, infection and puncture of other viscera have been reported previously [3][4][5][6]16,17]. The strength of our study is the lack of selection bias within our institution because all biopsied patients in the specific period of time were initially included in the analysis.…”

“…However, there is almost always a long time span of several months between the visual or palpatory appearance of a seeding metastasis and the US-guided biopsy that caused it, and thus it may be difficult to make a causal connection between the two. This fact may account for the very low frequency of seeding reported in large literature surveys and questionnaires and institutional studies, including a previously published, material of complications related to 8000 US-guided procedures performed at our institution wherein no incidence of seeding was encountered [3][4][5][6].…”

“…Frequency and mechanisms behind tumor seeding after biopsy are poorly elucidated; and reports regarding seeding after liver biopsy in patients with BC are not available. In the four largest surveys the range of the needle tract seeding after biopsy of abdominal lesions was miniscule (0-0.009%) [3][4][5][6]. Common to these studies was that they were based on patient and doctor reporting, without performing an active cross-sectional imaging verified tracing of seeding; and therefore true seeding rate was probably greatly underestimated.…”

EFSUMB guidelines 2015 on interventional ultrasound

“…Ultrasound-guided interventions (procedures) have revolutionized the everyday clinical practice during recent decades [63][64][65][66][67]. The advantages of ultrasoundguided interventions include an unsurpassed sharpness of detail and excellent controllability consequent to the real-time visual display, the wide availability of ultrasound equipment, and a simple and straightforward, easy to learn practical technique.…”