Tri-axial Biopsy Needle Cauterization During Splenic Biopsy

Abstract Objective We describe a novel and safe CT biopsy technique that we have termed the “Birmingham intervention tent technique (BITT).” This technique is ideal for biopsying osseous lesions where a direct approach is not possible due to difficult positioning. Methods The BITT uses a plastic surgical forceps clamp attached at an angle to the biopsy needle, creating a tent shape. The finger rings of the forceps is stabilized on the table. Results In our institution, we have already used the BITT successfully in over 10 cases. Conclusion The BITT is an inexpensive and reproducible technique.

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Inadvertent arterial & venous injury by bone marrow biopsy needle: case report on rescue embolization techniques

CVIR Endovascular ◽

10.1186/s42155-020-00172-9 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Chris Siu-Chun Tsai ◽

Simon Chun-Ho Yu

Keyword(s):

Bone Marrow ◽

Bone Marrow Biopsy ◽

Vascular Injury ◽

Iliac Artery ◽

Morbidity And Mortality ◽

Biopsy Needle ◽

Venous Injury ◽

Patient Morbidity ◽

Internal Iliac ◽

Life Threatening

Abstract Background Bone marrow biopsy is a common medical procedure for diagnosis and characterization of haematological diseases. It is generally regarded as a safe procedure with low rate of major complications. Inadvertent vascular injury is however an uncommon but important complication of bone marrow biopsy procedure. The knowledge of a safe and effective embolization method is crucial for interventional radiologists to reduce significant patient morbidity and mortality, shall such inadvertent vascular injury occurs. Case presentation Bedside bone marrow biopsy was performed for an elderly gentleman to evaluate for his underlying acute leukaemia. Biopsy needle inadvertently injured the internal iliac artery and vein during the procedure. Coil embolization was carefully performed across injured arterial segment via the culprit biopsy needle until contrast cessation. Concomitant venous injury was subsequently confirmed on angiography when the needle was withdrawn for a short distance from the iliac artery. This venous injury was tackled by further withdrawing the biopsy needle to distal end of the bone marrow tract for tract embolization with coils and gelatin sponges. High caution was made to avoid coil dislodgement into the iliac vein, to prevent pulmonary embolism. Patient was clinically stable throughout the procedure. Post-procedure contrast CT shows no pelvic haematoma or contrast extravasation. Conclusions This case illustrates rescue embolization techniques for rare life-threatening concomitant internal iliac arterial and venous injuries by a bone marrow biopsy needle. Interventional radiologists can play an important role in carrying out precise embolization to avoid significant patient morbidity and mortality in the case of life-threatening haemorrhage.

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