Vascular Complications following Needle Puncture of the Liver

Abstract

Needle biopsy and transhepatic cannulation of blood vessels and bile ducts of the liver have been used for several years. Owing to the proximity of the systems, short circuits may sometimes occur after puncture. It was therefore thought worthwhile to investigate experimentally possible vascular complications following the procedure.Material and Methods. Twenty-eight Swedish land rabbits, weighing between 1.4 and 3.4 kg, were anaesthetized with pentobarbitone sodium intravenously. A catheter (OPP 60, OD/ID 1.15/0.75 mm) with a long tapered tip bent about 30 0 was introduced into the common hepatic artery through one of the femoral arteries under magnification fluoroscopy. Twofold (0.3 mm focal spot) or fourfold (0.1 focal spot) magnification angiography was performed with a film changer (AOT 24 em X 30 cm) and high pressure injector, 2 to 3 ml Isopaque Cerebral (meglumine metrizoate) being injected at a rate of about 0.5 ml/s, Technical data: 90 kV, 3.2 mAs, 0.032 s-twofold magnification, and 90 kV, 1.6 mAs and 0.05 s-fourfold magnification. RP film and Rubin screens. Film programme: 6/3,4/8 films/so

Altered findings of hepatic arteriography after radiofrequency ablation of hepatocellular carcinoma: comparison of pre-ablation and post-ablation angiograms

“…The frequency of the arterio-portal shunt after puncturing the liver with a needle depended on the interval between the needle puncture and the hepatic arteriography, as high as 50% within the first week and less than 10% after the first week (18). The arterio-portal shunt tended to close spontaneously in time.…”

Hepatic Arterioportal Fistulae: Two Case Reports and Review of the Literature

“…In a prospective study, Okuda et al showed that 5.4% of 93 patients had evidence of an arterio portal fistula on hepatic angiography 3 days to 4 weeks after a percutaneous liver biopsy [6]. Many of the fistulae that are acquired through trauma spontaneously close with time, especially if they are small [3,5,9]. In addition to trauma, arterio portal fistulae can also develop from the rupture of a hepatic artery aneurysm into a portal vein or from a focal liver lesion such as a tumor [10].…”

Iodized oil retention due to postbiopsy arterioportal shunt: a false positive lesion in the investigation of hepatocellular carcinoma

“…A relatively high frequency of arterioportal shunt as a sequela of percutaneous needle biopsy has been described. Hellekant [17] reported that frequency of arteriovenous shunt depended on the interval between biopsy and angiography; incidence was as high as 50% in less than 1 week, dropping to 10% after 1 week. This confirms the tendency for a shunt to close spontaneously in time.…”