title: Safety of ultrasound-guided fine needle aspiration biopsy of neck lesions in patients taking antithrombotic/anticoagulant medications.
abstract: We examined records of patients who underwent ultrasound-guided fine needle aspiration biopsy (USGFNAB) of neck lesions to determine whether there was a significantly increased incidence of bleeding complications in patients on antithrombotic and/or anticoagulant (AT/AC) medications compared to patients not receiving AT/AC therapy. Our institutional review board approved this Health Insurance Portability and Accountability Act-compliant retrospective examination of patients' medical data without requiring informed consent. The records of 593 patients (422 women and 171 men ranging from 18 to 91 years of age) who underwent USGFNAB of 788 total neck lesions over an 18-month period were reviewed to determine AT/AC medication used and evidence of USGFNAB-related bleeding complications. Of these, 144 patients (24.3%) were taking one or more AT/AC medications including aspirin, clopidogrel, heparin, and warfarin. The χ2 test was used to assess statistically significant differences in the incidence of USGFNAB-related bleeding complications between patients who were on daily AT/AC medications (test group) and patients who were not (control group). Six USGFNAB-related hematomas (1.0%) occurred. Two hematomas developed in patients on AT/AC medications, and 4 hematomas developed in patients who did not take AT/AC medications (χ = 0.27, df = 1, P = 0.603). This study shows no statistically significant difference in the incidence of hematoma formation after USGFNAB of neck lesions in patients taking AT/AC medications compared to patients not taking AT/AC medications. On the basis of these data, there is no benefit, with regard to incidence of bleeding complications, to discontinuing AT/AC medications in patients undergoing USGFNAB of neck masses.
authors.affiliation: Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
authors.forename: Monzer M
authors.initials: MM
authors.lastname: Abu-Yousef
authors.forename: Joshua H
authors.initials: JH
authors.lastname: Larson
authors.forename: David M
authors.initials: DM
authors.lastname: Kuehn
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Wu
authors.forename: Archana T
authors.initials: AT
authors.lastname: Laroia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D016009:Chi-Square Distribution; D000077144:Clopidogrel; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006406:Hematoma / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006470:Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives; D018084:Ultrasonography, Interventional; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin