Postbiopsy splenic bleeding in a dog model: comparison of cauterization, embolization, and plugging of the needle tract.
OBJECTIVE
The purpose of our study was to compare radiofrequency cauterization, embolization using an absorbable gelatin sponge, and a Histoacryl-Lipiodol mixture plugging as postbiopsy bleeding reduction methods after splenic core needle biopsy in a dog model.


METHODS
Eleven mongrel dogs were randomly separated into nonheparinized (n = 5) and heparinized (n = 6) groups. Eight splenic biopsies per animal were performed using an 18-gauge automated core biopsy needle: two as controls, two ablated by radiofrequency, two embolized using an absorbable gelatin sponge, and two plugged using a Histoacryl-Lipiodol mixture. Procedure times and postbiopsy bleeding amounts were assessed. Statistically significant differences were determined by repeated measures analysis of variance; the Tukey-Kramer test for multiple comparisons was used for post hoc comparisons. Three-day follow-up CT scans were obtained to check for procedure-related complications or delayed bleeding.


RESULTS
The postbiopsy bleeding reduction groups showed significantly less blood loss than the control group for both the nonheparinized (p < 0.0001) and heparinized groups (p < 0.0001). In the heparinized group, both radiofrequency cauterization (p < 0.01) and gelatin sponge embolization (p < 0.05) significantly reduced bleeding compared with Histoacryl-Lipiodol mixture plugging. Gelatin sponge embolization was the longest procedure (p < 0.001). On follow-up CT, no delayed bleeding was observed. However, multiple Histoacryl-Lipiodol emboli were observed in the splenic and portal veins in all the dogs we treated.


CONCLUSIONS
Radiofrequency cauterization was found to be the most useful postbiopsy bleeding reduction method in terms of the amount of bleeding and the procedure time.
Choi
Seung Hong
SH
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744.
Lee
Jeong Min
JM
Lee
Kyoung Ho
KH
Kim
Se Hyung
SH
Lee
Jae Young
JY
Han
Joon Koo
JK
Choi
Byung Ihn
BI
D000704:Analysis of Variance; D000818:Animals; D001707:Biopsy, Needle; D017115:Catheter Ablation; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods; D004659:Enbucrilate / Q000627:therapeutic use; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques; D007459:Iodized Oil / Q000627:therapeutic use; D023421:Models, Animal; D011897:Random Allocation; D013154:Spleen / Q000098:blood supply* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D007459:Iodized Oil; D004659:Enbucrilate