Hemostasis of active bleeding from the liver with percutaneous microwave coagulation therapy under contrast-enhanced ultrasonographic guidance: an experimental study.
OBJECTIVE
The purpose of this study was to investigate the feasibility of percutaneous microwave coagulation therapy (PMCT) guided by contrast-enhanced ultrasonography (CEUS) for controlling active bleeding in rabbit livers.


METHODS
Twenty actively bleeding rabbit liver models, produced with an 18-gauge semiautomatic biopsy needle and confirmed with CEUS, were randomly divided into 2 groups: a PMCT group (n=10, with a microwave antenna placed into the bleeding site under ultra-sonographic guidance and worked at 60 W for 30 seconds on average) and a control group (n=10, with the active bleeding site not treated). After therapy procedures were performed, lactated Ringer's solution resuscitation was then performed in both groups to maintain the mean arterial pressure at 70 mm Hg for 1 hour. The intraperitoneal blood loss, total resuscitation volume, mean arterial pressure, and hematocrit value were recorded. Macroscopic and microscopic examinations were performed at the end of the study.


RESULTS
After PMCT, the former bleeding site appeared on CEUS as a round or an oval area devoid of contrast. The PMCT group had lower blood loss (30.4+/-7.2 versus 101.6 +/- 18.2 mL; P< .05) and a lower total resuscitation volume (56.5+/-10 versus 186+/-36.6 mL; P< .05) than the control group. The mean hematocrit value in the PMCT group was significantly higher than that in the control group (26%+/-4% versus 19%+/-4%; P< .05) at the end of the experiment.


CONCLUSIONS
Contrast-enhanced ultrasonographically guided PMCT significantly decreased blood loss in a rabbit model of active liver bleeding. It provides a simple and quick method to control blood loss in liver injuries with active bleeding.
Song
Hong-Ping
HP
Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, 17 W Changle Rd, 710032 Xi'an, China. songhp@hotmail.com
Yu
Ming
M
Zhang
Jun
J
Han
Zeng-Hui
ZH
Su
Hai-Li
HL
Ren
Xiao-Long
XL
Wei
Zhang-Rui
ZR
Luo
Wen
W
He
Jian-Guo
JG
Zhou
Xiao-Dong
XD
D000818:Animals; D003287:Contrast Media; D005240:Feasibility Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006487:Hemostasis; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008872:Microwaves / Q000627:therapeutic use*; D010743:Phospholipids; D011817:Rabbits; D013459:Sulfur Hexafluoride; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride