Real-time ultrasound-guided renal biopsy with a biopsy gun in children: safety and efficacy

Levart, A Kenig T Kersnik

doi:10.1080/08035250152708789

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…Most perirenal hematomas are minor without clinical significance. Serious complications are infrequent when traditional risk factors like hypertension and bleeding diathesis are not overlooked [ 13 , 14 ]. The procedure-related complications have been reported as the second most common nonsurgical medical error observed in the Harvard Medical Practice Study [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

Prasad

Kumar

Manjunath

et al. 2015

Clinical Kidney Journal

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BackgroundPercutaneous renal biopsy (PRB) can result in serious complications. The study is aimed to compare the biopsy yield and complications rate of the real-time ultrasonagram (USG)-guided PRB and needle tracking with and without needle guide in two different study periods.MethodsWe compared the yield and complications of 2138 kidney biopsies performed in two different periods, 1510 biopsies during the first period from April 2004–December 2010 and 628 biopsies during second period from January 2011–March 2013. All biopsies in both periods were performed by nephrologists. Radiologists provided the real-time image without needle guide during the first period while nephrologists performed both imaging and biopsy with needle guide during the second period.ResultsOf all the 2138 patients, 226 (10.5%) patients developed 118 minor and 108 major complications. Only 13 (2.1%) major complications occurred in the second period and 95 (6.7%) in the first period (P < 0.001). The relative risk of developing a major complication without guide was 3.04 times greater than that of the biopsies performed with use of the guide. The mean number of glomeruli per biopsy obtained during the second period (17.98 ± 6.75) was significantly greater than that of the first period (14.14 ± 6.01) (P = 0.004). The number of passes to acquire adequate tissue (P = 0.001) and percentage of cortex on biopsy (P = 0.001) were also significantly better in the second period. The optimal observation period post biopsy is 24 h.ConclusionsReal-time USG imaging supported by needle guide device is associated with better biopsy yield and fewer complications.

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Section: Introductionmentioning

confidence: 99%

Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

Prasad

Kumar

Manjunath

et al. 2015

Clinical Kidney Journal

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“…Bleeding manifestations include hematuria, hematoma, and profuse bleeding with a consequent need for blood transfusions, coil embolization, or surgical procedures such as nephrectomy; rarely, death can result [ 3 ]. Serious complications are rare when risk factors such as hypertension, bleeding, and clotting tests are within acceptable ranges [ 7 , 8 ]. Our patient had severe hypertension periprocedurally, which is a well-known risk factor for bleeding.…”

Section: Discussionmentioning

confidence: 99%

Salvage of bleeding renal allograft following biopsy, with suture technique: a case report

et al. 2016

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BackgroundPercutaneous renal biopsy is a valuable procedure in the management of and prognostication for patients with renal disease. Complications, although rare, occur with renal biopsies. Arteriovenous fistulas and heavy bleeding are notable complications. In this report, we describe simple suturing of the biopsy tract for salvage of a graft destined for a nephrectomy due to a profusely bleeding arteriovenous fistula.Case presentationA 20-year-old Sri Lankan man with end-stage renal disease due to steroid-resistant nephrotic syndrome underwent a renal transplant. He had poor urine output following the surgery, and a renal biopsy was performed to diagnose his renal pathology. He experienced poorly controlled postprocedural hypertension, and he had four episodes of gross hematuria that required blood transfusion. Coil embolization was delayed due to technical issues, and a graft nephrectomy was planned following the fourth episode of hematuria, which was the most severe. A Doppler scan revealed a slender, iatrogenic arteriovenous fistula corresponding to the biopsy tract, with very high flow rates. With knowledge of the anatomy of the fistula, we performed suturing of the tract to obliterate the fistula as a last resort to salvage the graft. The surgical procedure stopped the bleeding, and the patient made a full recovery with an excellent quality of life.ConclusionsIn our patient, a renal transplant biopsy revealed acute tubular necrosis. The incidence and treatment of fistulas and differences in complication rates among native and graft kidney biopsies are discussed.

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Measuring hemoglobin prior to early discharge without routine surveillance ultrasound after percutaneous native renal biopsy in children

et al. 2017

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Real-time ultrasound-guided renal biopsy with a biopsy gun in children: safety and efficacy

Abstract: The results confirm that real-time ultrasound-guided RB with a biopsy gun is a safe procedure and provides information that is very beneficial to patients.

Cited by 7 publications

References 13 publications

Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

Salvage of bleeding renal allograft following biopsy, with suture technique: a case report

Measuring hemoglobin prior to early discharge without routine surveillance ultrasound after percutaneous native renal biopsy in children

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