Sonographic Diagnosis of a Superior Gluteal Artery Arteriovenous Fistula and Pseudoaneurysm After Bone Marrow Biopsy

Yap, Woon Teck; Jeffrey, R. Brooke

doi:10.7863/ultra.15.08048

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…While bone marrow biopsy complications may not be directly associated with obesity, the inciting factor is often an inability to determine landmarks and/or needle position. [21][22][23][24][25][26] Performing bone marrow biopsy under CT guidance eliminates the need for bony landmarks and should be considered as a safe alternative in these patients.…”

Section: Discussionmentioning

confidence: 99%

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Manchec

Limback

Liu

et al. 2020

J Clin Interv Radiol ISVIR

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Purpose Obesity can make bone marrow biopsy using manual landmarks as guidance technically challenging. This retrospective review was performed to assess the safety and technical success of performing bone marrow biopsies with computed tomography (CT)–guidance in obese patients. Materials and Methods This single-institution, retrospective study included 1,016 CT-guided bone marrow biopsies performed between 2009 and 2016. Thirty-four percent (n = 348) were performed in patients with a body mass index (BMI) of 30 kg/m2 or greater, and 7% (n = 75) were performed in patients with a BMI greater than 40 kg/m2. Demographic information, BMI, and complications were reviewed. The primary endpoint was technical success and procedurally related hemorrhagic complication. The electronic medical record was reviewed to identify procedural related hemorrhagic complications, Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 or above. The complication rates in obese patients were compared with patients with a BMI less than 30 kg/m2. Results Biopsy was successfully performed in all patients. No biopsies resulted in a CTCAE Grade 3 or above complication. There was no difference in complication rate (0%) based on BMI. For patients with a BMI < 30 kg/m2, BMI ≥ 30 kg/m2, and BMI > 40 kg/m2, complications rates were 0% (95% confidence interval [CI]: 0–0.4%), 0% (95% CI: 0–0.9%), and 0% (95% CI: 0–4%), respectively. Conclusions CT-guided bone marrow biopsy in obese patients can be performed with a high rate of technical success and is safe. If patient body habitus limits the ability to palpate physical landmarks needed to perform bone marrow biopsy without image guidance, CT-guided bone marrow biopsy should be considered.

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Section: Discussionmentioning

confidence: 99%

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Manchec

Limback

Liu

et al. 2020

J Clin Interv Radiol ISVIR

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“…The injection of thrombin under ultrasound guidance, which has been associated with good outcomes, represents an alternative approach to the treatment of iatrogenic pseudoaneurysms ( 11 , 12 ). Neesse et al described a case of bleeding from the hypogastric artery after BM biopsy.…”

Section: Discussionmentioning

confidence: 99%

The Endovascular Management of an Iatrogenic Superior Gluteal Artery Rupture Following Bone Marrow Biopsy

Gregorio¹,

Spalla²,

Padricelli³

et al. 2017

Intern. Med.

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We herein report an uncommon case of a life-threatening retroperitoneal hematoma after a bone marrow biopsy. Two hours after iliac crest bone harvesting, the patient experienced syncope and severe hypotension. Urgent contrast-enhanced computed tomography demonstrated extravasation from the superior gluteal artery. Transcatheter coil embolization was performed successfully, without complications. Life-threatening complications caused by retroperitoneal bleeding after bone marrow biopsy are very rare. There are few reports on the use of endovascular treatment in the management of life-threatening hemorrhagic complications after bone marrow biopsy.

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“…e experience is to retract the catheter into the hepatic artery or the left and right hepatic artery trunks and then inject a proper amount of lipiodol into the superselective subsegment to prevent the omission of smaller lesions and to achieve both diagnosis and treatment. postembolic syndrome, cholecystitis, hepatic dysfunction, and gastroduodenal lesions; generally symptomatic support can be treated [21]. Hepatic artery-portal sputum has obvious stealing function, which causes a large amount of hepatic artery blood to be shunted to the portal vein, hepatic ischemia, and hypoxia.…”

Section: Clinical Significance Of Embolization In the Treatment Of Hementioning

confidence: 99%

Imaging Diagnosis and Interventional Treatment for Hepatocellular Carcinoma Combined with Arteriovenous Fistula

Cai

Ran

Song

et al. 2021

Journal of Healthcare Engineering

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In order to explore the imaging diagnosis methods and interventional treatment effects of hepatocellular carcinoma combined with hepatic arteriovenous fistula (HAVF), a total of 120 patients, who were diagnosed as hepatic carcinoma with arteriovenous shunting and underwent medical imaging diagnosis and interventional surgery therapy at a designated hospital by this study from December 2014 to December 2018, were chosen as study subjects. Digital subtraction angiography was performed to analyze the imaging features of hepatocellular carcinoma combined with HAVF in each patient; then, according to these imaging diagnosis results, gelatin sponge or coil was used to block the fistula; mitomycin, carboplatin powder, and lipiodol mixed emulsion was combined or separately utilized for hepatic tumor embolization, in which iodized oil embolization chemotherapy was used for patients with mild paralysis; gelatin sponge granule embolization chemotherapy was used for moderate paralysis patients at their first intervention, and, after about 1 month, if the sputum disappeared, iodized oil embolization was used again; and hepatic arterial infusion chemotherapy was used only for patients with severe paralysis. The results show that the central type of HAVF is characterized by early angiography of portal vein and large branches and tumor staining after portal vein’s angiography; the peripheral type of HAVF is characterized by portal vein branching in hepatic tumor and double rail sign accompanied by the arterial branch; 112 cases of patients completed embolization chemotherapy; 8 cases of patients only received chemotherapy perfusion; in 109 cases of patients sputum disappeared or shunt decreased at first treatment; and in 113 cases of patients iodine oil was well deposited or the tumor was stably reduced; most of the symptoms of refractory ascites, diarrhea, and upper gastrointestinal bleeding were controlled or improved, and there were no complications such as pulmonary embolism and hepatic failure. Therefore, HAVF increases the difficulty of interventional therapy, but, as long as the positive and appropriate treatment measures are taken, it can still achieve better curative effect without serious complications, which can effectively alleviate the clinical symptoms of patients and improve the quality of life of patients. The results of this study provide a reference for the further researches on imaging diagnosis and interventional treatment for hepatocellular carcinoma combined with arteriovenous fistula.

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Sonographic Diagnosis of a Superior Gluteal Artery Arteriovenous Fistula and Pseudoaneurysm After Bone Marrow Biopsy

Cited by 5 publications

References 9 publications

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

The Endovascular Management of an Iatrogenic Superior Gluteal Artery Rupture Following Bone Marrow Biopsy

Imaging Diagnosis and Interventional Treatment for Hepatocellular Carcinoma Combined with Arteriovenous Fistula

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