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Postbiopsy Splenic Bleeding in a Dog Model: Comparison of Cauterization, Embolization, and Plugging of the Needle Tract

Seung Hong Choi1, Jeong Min Lee1, Kyoung Ho Lee2, Se Hyung Kim1, Jae Young Lee1, Joon Koo Han1 and Byung Ihn Choi1

1 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,
2 Department of Radiology, Seoul National University Bundang Hospital, Seoul, Korea.



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  		Fig. 1A —Radiofrequency cauterization of splenic biopsy tract. Photograph of 15-gauge introducer sheath shows stainless insulation, leading 8-mm uninsulated region (straight arrow), and transducer (curved arrow) used to connect radiofrequency generator.

 


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  		Fig. 1B —Radiofrequency cauterization of splenic biopsy tract. Photograph shows splenic biopsy needle and introducer sheath complex.

 


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  		Fig. 1C —Radiofrequency cauterization of splenic biopsy tract. Photograph shows radiofrequency cauterization of splenic biopsy site after removal of biopsy needle.

 


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  		Fig. 2A —Histoacryl-Lipiodol (tissue adhesive, B. Braun-iodized oil, Guerbet) mixture plugging in splenic biopsy tract. Photographs show 18-gauge biopsy needle placed through its vascular sheath (A), splenic biopsy procedure needle and vascular sheath complex (B), and Histoacryl-Lipiodol mixture plugging of splenic biopsy site after biopsy needle removal (C).

 


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  		Fig. 2B —Histoacryl-Lipiodol (tissue adhesive, B. Braun-iodized oil, Guerbet) mixture plugging in splenic biopsy tract. Photographs show 18-gauge biopsy needle placed through its vascular sheath (A), splenic biopsy procedure needle and vascular sheath complex (B), and Histoacryl-Lipiodol mixture plugging of splenic biopsy site after biopsy needle removal (C).

 


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  		Fig. 2C —Histoacryl-Lipiodol (tissue adhesive, B. Braun-iodized oil, Guerbet) mixture plugging in splenic biopsy tract. Photographs show 18-gauge biopsy needle placed through its vascular sheath (A), splenic biopsy procedure needle and vascular sheath complex (B), and Histoacryl-Lipiodol mixture plugging of splenic biopsy site after biopsy needle removal (C).

 


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  		Fig. 3 —Photograph shows gelatin sponge (arrow) embolization of splenic biopsy site after removal of biopsy needle and hemostatic valve of vascular sheath.

 


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  		Fig. 4 —Axial contrast-enhanced portal venous phase helical CT scan obtained 3 days after radiofrequency cauterization of splenic biopsy site shows unenhanced splenic area (arrow), which suggests necrosis.

 


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  		Fig. 5 —Axial unenhanced helical CT scan obtained 3 days after Histoacryl-Lipiodol (tissue adhesive, B. Braun-iodized oil, Guerbet) mixture plugging of splenic biopsy site shows Histoacryl-Lipiodol mixture with high attenuation (arrow) in spleen.

 


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  		Fig. 6 —Portal venous phase CT scan with 3D reconstruction using 3D software program (Rapidia, Infinitt) shows multiple Histoacryl-Lipiodol (tissue adhesive, B. Braun-iodized oil, Guerbet) mixture emboli in portal vein (arrows) and splenic vein (arrowhead). Multiple bright dots in liver with no annotation are also portal emboli.

 

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