Use of fibrin sealant to reduce bleeding after needle liver biopsy in an anticoagulated canine model: work in progress.
OBJECTIVE
Needle biopsy of the liver is a common diagnostic procedure. Although relatively safe, bleeding remains a potential complication and may occur more frequently in patients with coagulopathy. The purpose of this study was to evaluate the utility of a fibrin sealant in preventing bleeding after a 15-gauge needle biopsy of the liver in a canine model heparinized to simulate coagulopathy.


METHODS
Fibrin sealant was delivered to biopsy tract sites in eight dogs anticoagulated with heparin (activated clotting time 387 seconds +/- 94) using the same sheath system that was employed to obtain the biopsy specimen.


RESULTS
The results demonstrated complete hemostasis in the sealant-plugged tracts as compared to controls. Continuous bleeding was observed in none of the fibrin sealant-treated sites, compared with all of the control biopsy sites (P = .0078).


CONCLUSIONS
These results demonstrate the high degree of efficacy of fibrin sealant delivered through a sheath system in plugging liver biopsy tracts and eliminating bleeding in a severely coagulopathic animal model. This indicates that fibrin sealant use in cutting needle biopsies can reduce major and minor complications associated with the procedure.
Falstrom
J K
JK
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22906-0005, USA.
Moore
M M
MM
Caldwell
S H
SH
Matsumoto
A H
AH
Abbott
R D
RD
Spotnitz
W D
WD
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004195:Disease Models, Animal; D004285:Dogs; D016503:Drug Delivery Systems; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage / Q000138:chemical synthesis / Q000627:therapeutic use*; D006470:Hemorrhage / Q000517:prevention & control*; D006490:Hemostatics / Q000008:administration & dosage / Q000138:chemical synthesis / Q000627:therapeutic use*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000517:prevention & control*; D009339:Needles; D013594:Syringes; D014014:Tissue Adhesives / Q000138:chemical synthesis / Q000627:therapeutic use*
D000925:Anticoagulants; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014014:Tissue Adhesives; D006493:Heparin