4:21 PM Abstract No. 370 Transfemoral transcaval core-needle liver biopsy: safety and efficacy in over 200 cases

Abstract

To investigate the safety, efficacy, and outcomes of transfemoral transcaval (TFTC) core-needle liver biopsies. We previously published our results of the first 66 patients using TFTC as an alternative to transjugular liver biopsy, where hepatic tissue is directly obtained through the intrahepatic inferior vena cava via a femoral venous approach. In this retrospective study, the medical, surgical, and radiological records of patients who underwent transvenous liver biopsies at a single institution between February 2014 and August 2017 was performed. This is a follow-up study where we present the outcomes and complications of over 200 patients. Procedural complications were classified according to the Society of Interventional Radiology guidelines. 204 total TFTC liver biopsies (61.5% male; mean age 51.1 ± 15.5 years) accounted for 75.0% (204/272) of the transvenous liver biopsies. Technical success was achieved in 98.5% (201/204) of cases. Histopathologic diagnoses were made in 198 cases (97.1%). Fragmented or limited samples in which a pathological diagnosis was still made occurred in 6 cases (3.0%). Complications occurred in 4 cases (1.9%). There was one case with a small subhepatic hematoma, not requiring any transfusion and one case with delayed bleeding at the femoral puncture site requiring a blood transfusion that was successfully treated with a figure eight stitch. Venous pressure measurements were requested in 171 cases and were successfully obtained in all. TFTC core-needle liver biopsy is a safe and highly effective method of obtaining hepatic tissue samples and venous pressure measurements.