Transvenous Liver Biopsy via the Femoral Vein

Khosa, Faisal; McNulty, James G.; Hickey, N; O'Brien, Patrick; Tobin, Anne; Noonan, Noreen; Ryan, Barbara; Keeling, P. W. N.; Kelleher, Dermot; McDonald, G. S. A.

doi:10.1016/s0009-9260(02)00576-7

Cited by 16 publications

(7 citation statements)

References 20 publications

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“…This is more often encountered in patients with a liver transplant where the normal anatomy is distorted and the weight of the unattached liver can rotate the drainage vasculature. Lack of transvenous access is another reason for technical failure; however, the use of alternative accesses such as the left internal jugular, 24 external jugular, 25 subclavian, or even femoral 26 vein is a possibility and may solve this issue.…”

Section: Resultsmentioning

confidence: 99%

Transjugular Liver Biopsy

Behrens

Ferral

2012

Semin intervent Radiol

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Liver biopsy is considered the gold standard for the evaluation of acute and chronic liver disorders. Transjugular liver biopsy (TJLB) was described by Dotter in 1964 and clinically performed for the first time by Hanafee in 1967. TJLB consists of obtaining liver tissue through a rigid cannula introduced into one of the hepatic veins, typically using jugular venous access. The quality of the TJLB specimens has improved so much that the samples obtained by this method are comparable with those obtained with the percutaneous technique. TJLB is indicated for patients with coagulopathy, ascites, peliosis hepatis, morbid obesity, liver transplant, or in patients undergoing a transjugular intrahepatic portosystemic shunt procedure. The technical success rate for a TJLB procedure ranges from 87 to 97%. Sample fragmentation has been reported in 14 to 25% of the TJLB samples. The complication rates are low and range between 1.3% and 6.5%. The purpose of this article is to provide a review of the fundamental aspects of the TJLB procedure, including technique, indications, contraindications, results, and complications.

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Section: Resultsmentioning

confidence: 99%

Transjugular Liver Biopsy

Behrens

Ferral

2012

Semin intervent Radiol

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“…Therefore we were able to use the right IJV in all 93 patients, but when the right IJV is tortuous or occluded, the left IJV or femoral vein can be used as the access site (18). However, the femoral approach needs a different biopsy set.…”

Section: Discussionmentioning

confidence: 99%

Transjugular Liver Biopsy: Results of 97 Patients

Dönmez¹,

Kahriman²,

Özcan³

et al. 2012

Balkan Med J

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Objective: To evaluate the feasibility and efficacy of transjugular liver biopsy in patients with contraindicated percutaneous biopsy. Materials and Methods:Between June 2005 and April 2010, 97 patients who were admitted for transjugular liver biopsy were enrolled in this retrospective study. All liver biopsies were obtained using an 18 gauge Quick-Core liver biopsy set through the right hepatic vein via the internal jugular vein. Clinical indication, histopathological diagnosis, and complications were noted.Results: Primary technical success was achieved in 93 (95.8%) patients. Hepatic veins could not be catheterized and opacified in two patients and in the remaining two patients the veins could be opacified and catheterized but we were not able to pass the biopsy needle into the hepatic vein because of the acute angle between the inferior vena cava and hepatic veins. At least two specimens were obtained from each patient. The most frequent histopathological diagnosis was cirrhosis. A subcutaneous hematoma around the puncture side was encountered in one patient.Conclusion: Transjugular liver biopsy is a feasible and effective alternative in patients with contraindication for percutaneous biopsy.

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“…One particular risk associated with this route is perforation of the liver capsule and intraperitoneal haemorrhage (McAfee, et al 1992). Even if the procedure was attempted via the femoral route capsular perforation was still a noted complication (Khosa, et al 2003). Khosa suggested that this complication could be avoided if biopsies were taken within a central area of the liver and biplane fluoroscopy was used.…”

Section: Transvenous Liver Biopsymentioning

confidence: 99%