title: Improved method for transjugular liver biopsy using imaging sheaths developed for balloon-occluded retrograde transvenous obliteration.
abstract: OBJECTIVE
  Patients with ascites or coagulation abnormalities and requiring a liver biopsy may undergo transjugular liver biopsy (TJLB) rather than percutaneous liver biopsy. Currently, the difficulty in maneuvering the sheath towards the hepatic vein keeps this procedure from being widely used. Therefore, the utility of imaging sheaths, typically used for balloon-occluded retrograde transvenous obliteration, during TJLB was examined.
  
  
  METHODS
  TJLB was conducted on 41 patients using conventional, Teflon vascular sheaths (9 Fr, 45 cm) and on 60 patients using S1 sheaths (8 Fr, 50 cm). The duration of TJLB procedures, and their associated complications were compared.
  
  
  RESULTS
  The mean duration of the procedure was 26.9±7.94 minutes in the group undergoing TJLB with Teflon sheaths, significantly longer (p <0.01) than 20.1±4.52 minutes in the patients using S1 sheaths. However, in two (3.3%) of the S1 sheath patients, the sheaths had to be replaced with Teflon TJLB sheaths.
  
  
  CONCLUSIONS
  This study demonstrates that liver biopsies can be successfully collected by TJLB using S1 sheaths instead of the Teflon sheaths. This substitution for a more flexible material allows for a shorter invasive intervention time for patients for which percutaneous liver biopsy is not an option.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kubota
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.forename: Aiko
authors.initials: A
authors.lastname: Nagashima
authors.forename: Kanae
authors.initials: K
authors.lastname: Hirose
authors.forename: Keiichi
authors.initials: K
authors.lastname: Seki
authors.forename: Terasu
authors.initials: T
authors.lastname: Honma
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000295:instrumentation*; D001707:Biopsy, Needle / Q000379:methods*; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011237:Predictive Value of Tests; D015641:Radiography, Interventional; D013997:Time Factors; D062666:Vascular Access Devices
chemical_list: D011138:Polytetrafluoroethylene