Renal Biopsy with Forceps through the Femoral Vein

Bilbao, J.I.; Idoate, Fernando; Joly, M.; Vázquez, Carmen; Sangro, Bruno; Larrea, J. A.; Longo, Jesús M.; Pardo, Javier

doi:10.1016/s1051-0443(95)71152-6

Cited by 14 publications

(8 citation statements)

References 12 publications

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“…Of course, the close monitoring of patients for 24 hours after the procedure and the possibility of rapid embolization increase the safety of the procedure. The evaluation of a new technique of transfemoral renal biopsy with a flexible forceps in high-risk patients was reported recently by Bilbao et al (27). In their study, samples adequate for diagnosis were obtained from 13 (81%) of the 16 patients, and the mean number of glomeruli per procedure was 12.6 (range, 0-39 glomeruli).…”

Section: Discussionmentioning

confidence: 90%

“…Trigaux et al (28) found 38 (3.7%) retrocaval renal veins in a series of 1,014 patients with contrast materialenhanced spiral CT scans. The transfemoral approach reported by Bilbao et al (27), in which a 7-F, 100-cm-long biopsy forceps was used, could be recommended in both situations. We performed biopsy in the left kidney without difficulty in 13 instances.…”

Section: Discussionmentioning

confidence: 99%

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Transjugular versus Percutaneous Renal Biopsy for the Diagnosis of Parenchymal Disease: Comparison of Sampling Effectiveness and Complications

Cluzel

Martinez²,

Bellin³

et al. 2000

Radiology

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Transjugular versus Percutaneous Renal Biopsy for the Diagnosis of Parenchymal Disease: Comparison of Sampling Effectiveness and Complications

Cluzel

Martinez²,

Bellin³

et al. 2000

Radiology

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“…TJRB may become an even more interesting method with the technique of sonographic guidance [16] or with the advent of the newest method of transvenous renal sampling, i.e. transfemoral renal biopsy with forceps [6].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, there are still some patients in whom this reputedly safe percutaneous maneuver should not be performed due to the unacceptable risk of hemorrhage. Therefore, some novel techniques have been developed in the last decade [5][6][7][8] and transjugular renal biopsy (TJRB) could be considered as the most important one.…”

Section: Introductionmentioning

confidence: 99%

Transjugular Renal Biopsy

Rychlík¹,

Petrtýl²,

Tesař³

et al. 2001

Kidney Blood Press Res

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Background: Transjugular renal biopsy (TJRB) is still a novel technique of renal tissue sampling exploiting the transjugular route. TJRB should be performed particularly in situations when the percutaneous route is precluded, i.e. especially in patients with clotting disorders. In the past, only a few papers reported the experience with larger numbers of patients. The goal of this paper is to analyze our experience with TJRB. Methods and Results: From 1993 to 1999, 67 patients, mean age 49.8 years (SD ± 10.2), male/female ratio 40/27, underwent TJRB. Fifty-two patients (78%) suffered from renal insufficiency and 19 of them (28%) were on dialysis treatment at the time of TJRB. Arterial hypertension was recorded in 42%. The combined kidney and liver biopsy (46%) and clotting disorders (39%) were the most frequent indications for performing TJRB. Renal tissue was yielded in 53 patients (79%) but a sample sufficient for histological diagnosis was taken in 49 (73%), reaching on average 10.8 glomeruli. Altogether 19 different histological entities were disclosed and out of them, vascular nephrosclerosis (12%), necrotizing and crescentic glomerulonephritis, IgA nephropathy (IgAN) and amyloidosis (three latter per 10%) represented the most frequent diagnoses. TJRB was combined with liver biopsy in 31 patients (46%) and/or hepatic vein catheterization in 22 patients (33%) confirming portal hypertension in 8. The clinically significant liver histology was found in 20 patients, of them cirrhosis/fibrosis in 8, chronic hepatitis in 4 and steatosis in 5. Among those 20 patients, IgAN was disclosed as the most common renal diagnosis (6). Clinically symptomatic complications were recorded in 12 cases (18%) but 9 of them suffered from clotting disorders. Complications included development of subcapsular hematoma in 6 cases, macroscopic hematuria in 4 cases, and hypovolemic hemorrhagic shock in 2. One patient had to undergo surgical treatment. Dividing the patients into a subgroup with or without clotting disorders, the complication rate was 34 vs. 7%. Conclusions: TJRB is a new diagnostic method, which, looking at its indications, facilitates the diagnosis of glomerulopathies in patients who could not be considered for percutaneous renal biopsy, particularly due to clotting disorders. The technical aspect of this procedure plays a fundamental role in the final risk/benefit ratio but if done correctly it involves acceptable risk and is well tolerated.

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“…In these patients other options for biopsy, e.g. open renal [2,3], laparoscopic renal [4][5][6][7], endovascular [8][9][10], CT-guided and ureteroscopic [11] could be used; each has specific advantages and limitations.…”

Section: Authors From Varanasi India Describe How Artificial Neural mentioning

confidence: 99%

Laparoscopic renal biopsy: a 9‐year experience

Shetye¹,

Kavoussi²,

Ramakumar³

et al. 2003

BJU International

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Renal biopsy is a frequent procedure in patients with suspected intrinsic renal disease. In some patients the blind percutaneous approach is contraindicated; the authors from Johns Hopkins describe their experience over a 9‐year period using a laparoscopic approach. They found that adequate tissue could be obtained for biopsy in the large majority of cases, and that complications occurred in a tiny minority. Most patients were discharged within 24 h. They indicate the advantages in removing tissue by this method. Authors from Varanasi, India describe how artificial neural networks were used in an attempt to predict optimum renal stone fragmentation in patients undergoing ESWL. They were encouraged by the findings in what was essentially a pilot study, and felt that with a larger data set, the value of their network system could be enhanced. OBJECTIVES To present our experience and outcome of consecutive laparoscopic renal biopsy over a 9‐year period, as renal biopsy remains an important diagnostic procedure for evaluating proteinuria, haematuria and renal failure, but when percutaneous biopsy is contraindicated, a laparoscopic biopsy is an attractive option because it is minimally invasive. PATIENTS AND METHODS Seventy‐four patients (29 male, 45 female, mean age 45 years, range 3–79) had a laparoscopic renal biopsy taken for various indications, e.g. morbid obesity, solitary kidney, coagulopathy, failed percutaneous biopsy, high location of the kidney and poor visualization with ultrasonography. The kidney was approached via a laparoscopic retroperitoneal route using a two‐port technique, with the patient in the flank position. After identifying the kidney, one to five cortical biopsies were obtained with cup‐biopsy forceps. RESULTS Adequate tissue was obtained in 96% of the patients; the mean (range) operative duration was 123 (9–261) min and the estimated blood loss 67 (5–2000) mL. Forty‐three patients were discharged within 24 h. Complications occurred in 10 patients, with significant bleeding in three. One patient died after surgery, secondary to a perforated peptic ulcer while on high‐dose steroid therapy. CONCLUSION Laparoscopic renal biopsy is a safe and effective alternative to open renal biopsy for patients in whom percutaneous biopsy is not feasible. It offers the advantage of obtaining cortical biopsies and achieving haemostasis under direct vision. Adequate renal tissue is obtained in most cases. Recovery and convalescence are short for most patients.

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Renal Biopsy with Forceps through the Femoral Vein

Cited by 14 publications

References 12 publications

Transjugular versus Percutaneous Renal Biopsy for the Diagnosis of Parenchymal Disease: Comparison of Sampling Effectiveness and Complications

Transjugular versus Percutaneous Renal Biopsy for the Diagnosis of Parenchymal Disease: Comparison of Sampling Effectiveness and Complications

Transjugular Renal Biopsy

Laparoscopic renal biopsy: a 9‐year experience

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