Usefulness and safety of the “God’s Hand” pneumatic compression device for hemostasis in femoral catheterization

Abstract

M agnetic resonance imaging (MRI) is a widely used diagnostic tool for breast imaging in daily practice, with its high sensitivity to detect primary, recurrent, and residual breast cancer. Breast MRI serves as a reliable problem-solving tool in case of inconclusive mammography and ultrasonography (US) findings. It can be used to monitor the results of neoadjuvant chemotherapy and it may also contribute to preoperative evaluation of known lesions. With increasing use of MRI, number of breast lesions visible only on MRI and need for MRI-guided breast biopsy have increased (1). Second-look US can also be used for re-evaluation of these lesions; because US-guided biopsy is an easier, cheaper, and faster method if these lesions are visible on second-look US. According to a recently published meta-analysis, lesion detection rates with second-look US are variable in the literature (22.6%-82.1%). Mass lesions and malignant lesions were more likely to be detected at second-look US; average detection rates were 66% for masses, 29% for non-mass-like enhancement (NME) (2, 3). However, focal or NME lesions, which are less detectable than masses on second-look US, require MRI-guided biopsy in the majority of cases. According to the MRI-guided biopsy series in the literature, approximately 25%-35% of these lesions are diagnosed as malignant (4-9).Within this context, the aim of the present study is to assess the effectiveness of MRI-guided 10 Gauge (G) vacuum-assisted breast biopsies (VABB) performed at our institution and to examine the relationship between lesion characteristics and histopathologic results. B R E A S T I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to assess the effectiveness of magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB), evaluate and compare the characteristics and histopathologic findings of lesions, and overview the follow-up results of benign lesions. METHODSMRI findings and histopathologic results of breast lesions biopsied by MRI-guided VABB between 2013 and 2016 were retrospectively analyzed. MRI findings closely related with malignancy were investigated in particular. Follow-up results of benign lesions were evaluated. RESULTSMRI-guided VABB was applied to 116 lesions of 112 women. Of the lesions, 75 (65%) were benign, while 41 (35%) were malignant. Segmental (94%), clustered (89%), and clustered ring (67%) nonmass-like enhancement patterns were found to be more related with malignancy. False-negative rate of MRI-guided VABB was 12%, underestimation rate was 21%. One of the 54 followed-up benign lesions had a malignant result. CONCLUSION MRI-guided VABB is a reliable method for the diagnosis of breast lesions that are positive only on MRI. Follow-up results show that cancer detection rate is low for radio-pathologically concordant lesions. Further multicenter studies with larger patient population are needed to elucidate these results.You may cite this article as: Taşkın F, Soyder A, Tanyeri A, Öztürk VS, Ünsal A. Lesion characteristics, histopathologic r...

Comparison of the Effectiveness of the FemoStop Device and Sandbag Pressure on Hemostasis During Sheath Removal and Reducing Puncture Site Complications Following Transfemoral Coronary Angiography: A Randomized Controlled Trial

“…Kim et al demonstrated that a pneumatic compression device was effective and safe for the hemostasis of femoral catheterization. They observed that 4 h of bed rest was sufficient for hemostasis (28). Ghods et al compared the efficacy of sandbags and air cushions on complications after coronary angioplasty.…”

“Balloon Glove” Technique: An Easy Alternative to Pressure Dressing for Postoperative Hemostasis

“…The principle is similar to the use of mechanical compression devices at femoral artery catheterization sites to replace traditional manual compression, which is associated with personnel demands, fatigue of the operator's hand and arm, and patient discomfort. 4 In the event of bleeding or oozing at home, patients are routinely instructed to use their fingers to apply firm, continuous pressure directly on the wound for 20 minutes. In reality, patients may not be able to maintain adequate pressure because of fatigue and overestimation of the time lapsed.…”