Table 2.
Review of the literature regarding major bleeding after focal image-guided liver biopsy.
| Year | Patient Population | Number of Focal Liver Biopsies | Core vs FNA/Gauge/Passes | Image Guidance /Tract Embolized? | Permissive Coagulative Parameters | Bleeding Requiring Intervention (IR/ surgery) | Bleeding Requiring Transfusion | Bleeding Not Requiring Transfusion or Intervention | Overall Major Hemorrhage Rate | |
|---|---|---|---|---|---|---|---|---|---|---|
| Luening [11] | 1991 | 510 | 510 | FNA and core/14–21 gauge/3–4 passes | CT/Not specified | Inclusion parameters not specified | 0 | 1 | 0 | 0% (0/510) |
| Zins [12] | 1992 | 72 | 24 | Core/18 Gauge/1–2 passes | US/Gelatin and Thrombin | Inclusion parameters for focal biopsy patients not specified | 1 patient died of hemorrhage; specific treatments not reported | 4.2% (1/241) | ||
| Little [13] | 1996 | 476 | 296 | 18–20G/1–3 passes | 277 US and 19 CT/Not reported | Plt >50K PT <15 PTT <45 |
8 US 2 CT |
15 US 1 CT |
0 | 3.4% (10/296) |
| Riemann [14] | 2000 | 321 | 47 | Core/18g or 20g/2 Passes | US/Not reported | Quicktime >50% Plt >50K |
0 | 1 | 0 | 0% (0/47) |
| Giorgio [15] | 2003 | 12,962 | 16,648 | 2320 19G Core; 14,328 22G FNA/ not reported | US/Not reported | Plt >45K INR<1.7 Held anticoagulants 1 week prior, aspirin 2–3 days prior |
0 | 0 | 36/16,648 | 0% (0/16,648) |
| Terjung [16] | 2003 | 629 | 100 | Core/Menghini (Gauge not reported)/Not reported | US/Not reported | INR <1.4 Plt >50K |
1 patient died of hemorrhage; specific treatments not reported | 1% (1/100) | ||
| Kim [17] | 2007 | 352 | 201 | Core/10–18 Gauge/2 passes usually | US/Not specified | Inclusion parameters not specified | 1 | 1 | 0 | 0.5% (1/20) |
| El-Osta [18] | 2011 | 155 | 46 | Core/18g/not reported | CT vs US, exact number not specified /Not reported | Inclusion parameters not specified | 0 | 0 | 0 | 0% (0/46) |
| Westheim [19] | 2012 | 275 Pediatric Patients | 25 | Not Specified/18–22 gauge/1–8 passes | US/Not specified | Inclusion parameters not specified | 1 | 5 | 0 | 4% (1/25) |
| Aribas [20] | 2012 | 1300 | 1300 | Core and FNA/up to 20G/Four or less | US/Not Specified | Inclusion parameters not specified | 1 | 0 | Not specified | 0.08% (1/1300) |
| Median rate of major hemorrhage across all major studies in the last 30 years: | 0.29% | |||||||||