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

Zahrani, Yousof Al; Peck, David

doi:10.1186/s13256-016-0827-5

Cited by 16 publications

(11 citation statements)

References 9 publications

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“…While bone marrow biopsy complications may not be directly associated with obesity, the inciting factor is often an inability to determine landmarks and/or needle position. [21][22][23][24][25][26] Performing bone marrow biopsy under CT guidance eliminates the need for bony landmarks and should be considered as a safe alternative in these patients.…”

Section: Discussionmentioning

confidence: 99%

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Manchec

Limback

Liu

et al. 2020

J Clin Interv Radiol ISVIR

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Purpose Obesity can make bone marrow biopsy using manual landmarks as guidance technically challenging. This retrospective review was performed to assess the safety and technical success of performing bone marrow biopsies with computed tomography (CT)–guidance in obese patients. Materials and Methods This single-institution, retrospective study included 1,016 CT-guided bone marrow biopsies performed between 2009 and 2016. Thirty-four percent (n = 348) were performed in patients with a body mass index (BMI) of 30 kg/m2 or greater, and 7% (n = 75) were performed in patients with a BMI greater than 40 kg/m2. Demographic information, BMI, and complications were reviewed. The primary endpoint was technical success and procedurally related hemorrhagic complication. The electronic medical record was reviewed to identify procedural related hemorrhagic complications, Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 or above. The complication rates in obese patients were compared with patients with a BMI less than 30 kg/m2. Results Biopsy was successfully performed in all patients. No biopsies resulted in a CTCAE Grade 3 or above complication. There was no difference in complication rate (0%) based on BMI. For patients with a BMI < 30 kg/m2, BMI ≥ 30 kg/m2, and BMI > 40 kg/m2, complications rates were 0% (95% confidence interval [CI]: 0–0.4%), 0% (95% CI: 0–0.9%), and 0% (95% CI: 0–4%), respectively. Conclusions CT-guided bone marrow biopsy in obese patients can be performed with a high rate of technical success and is safe. If patient body habitus limits the ability to palpate physical landmarks needed to perform bone marrow biopsy without image guidance, CT-guided bone marrow biopsy should be considered.

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Section: Discussionmentioning

confidence: 99%

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Manchec

Limback

Liu

et al. 2020

J Clin Interv Radiol ISVIR

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“…Al Zahrani et al reported the first case of median sacral artery involvement. An emergency angiography and embolization procedure was performed using seven micro-coils ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

The Endovascular Management of an Iatrogenic Superior Gluteal Artery Rupture Following Bone Marrow Biopsy

Gregorio¹,

Spalla²,

Padricelli³

et al. 2017

Intern. Med.

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We herein report an uncommon case of a life-threatening retroperitoneal hematoma after a bone marrow biopsy. Two hours after iliac crest bone harvesting, the patient experienced syncope and severe hypotension. Urgent contrast-enhanced computed tomography demonstrated extravasation from the superior gluteal artery. Transcatheter coil embolization was performed successfully, without complications. Life-threatening complications caused by retroperitoneal bleeding after bone marrow biopsy are very rare. There are few reports on the use of endovascular treatment in the management of life-threatening hemorrhagic complications after bone marrow biopsy.

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“…Iatrogenic injury during bone marrow biopsy is rare, but has been reported in the literature (95). Reported cases of arterial injury include circumflex iliac artery, iliolumbar artery, superior gluteal artery, median sacral artery, and anterior hypogastric artery (86,(96)(97)(98)(99)(100)(101).…”

Section: Bone Marrow Biopsymentioning

confidence: 99%

Narrative review of vascular iatrogenic trauma and endovascular treatment

Smith¹,

Gage²,

Quencer³

2021

Ann Transl Med

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Iatrogenic injury is unfortunately a leading cause of morbidity and mortality for patients worldwide. The etiology of iatrogenic injury is broad, and can be seen with both diagnostic and therapeutic interventions. While steps can be taken to reduce the occurrence of iatrogenic injury, it is often not completely avoidable. Once iatrogenic injury has occurred, prompt recognition and appropriate management can help reduce further harm. The objective of this narrative review it to help reader better understand the risk factors associated with, and treatment options for a broad range of potential iatrogenic injuries by presenting a series of iatrogenic injury cases. This review also discusses rates, risk factors, as well as imaging and clinical signs of iatrogenic injury with an emphasis on endovascular and minimally invasive treatments. While iatrogenic vascular injury once required surgical intervention, now minimally invasive endovascular treatment is a potential option for certain patients. Further research is needed to help identify patients that are at the highest risk for iatrogenic injury, allowing patients and providers to reconsider or avoid interventions where the risk of iatrogenic injury may outweigh the benefit. Further research is also needed to better define outcomes for patients with iatrogenic vascular injury treated with minimally invasive endovascular techniques verses conservative management or surgical intervention.

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

Cited by 16 publications

References 9 publications

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

The Endovascular Management of an Iatrogenic Superior Gluteal Artery Rupture Following Bone Marrow Biopsy

Narrative review of vascular iatrogenic trauma and endovascular treatment

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