Abstract
Purpose
To report incidence of acute versus delayed presentations of bleeding requiring embolization
after focal liver biopsy, in correlation with angiographic findings and treatment
success rates. The available literature will be reviewed as well.
Materials and methods
Health Insurance Portability and Accountability Act-compliant institutional review
board approved retrospective review of 2180 consecutive patients undergoing 2335 targeted
liver biopsies at a tertiary-care cancer center. Hepatic arterial embolization episodes
within 30 days from biopsy were identified via radiology PACS. Electronic medical record review
was performed for indication of embolization and postembolization clinical course.
Results
The incidence of postbiopsy bleeding requiring embolization was 0.5% (12/2335 biopsies).
In those with bleeding, 1/12 (8%) had no hepatic arterial findings at angiography.
Angiographic hepatic arterial findings resolved after embolization in 11/11 patients
(100% technical success). Bleeding ceased after embolization in 10/12 patients (83%
clinical success). Complications were seen in 2/12 (17%) patients: cholecystitis and
hepatic infarct, respectively. Delayed presentation of bleeding (defined as >24 h postbiopsy) occurred in 5/12 (42%) patients; the longest latency was 12 days.
Conclusion
The overall incidence of bleeding requiring embolization in our population was 0.5%.
This complication rate compares favorably to the 0–4.2% (median: 0.29%) rate quoted
in the available, heterogeneous, literature on this topic. Delayed presentation occurred
in almost half of patients. Arterial embolization carries excellent technical and
clinical success rates.
Keywords
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Article info
Publication history
Published online: November 13, 2015
Accepted:
November 10,
2015
Received in revised form:
November 8,
2015
Received:
July 14,
2015
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
