Hooman Yarmohammadi MD, Abstract Co-Author: Nothing to Disclose

Kelly Mortell MD, Presenter: Nothing to Disclose

Waad Hanna MD, Abstract Co-Author: Nothing to Disclose

Nami Ramzi Azar MD, Abstract Co-Author: Research agreement, Toshiba Corporation

Dean Akira Nakamoto MD, Abstract Co-Author: Research Consultant , Galil Medical Ltd Speaker, Toshiba Corporation

Post-percutaneous renal biopsy complications have substantially decreased in the past decade. The current recommendation for optimal time of observing these patients is 24 hours. This is derived from studies performed in the 1990s. However, due to technical advances fewer complications are being observed and therefore shorter observation may be sufficient.

We performed a retrospective review of percutaneous core biopsies performed on native kidneys at our institution from 2001 through 2010. All biopsies were performed by five Interventional Radiologists using either 15G or 18G automated biopsy needle under real time ultrasound guidance. Data collected included age, sex, results of coagulation studies, plasma creatinine levels, pathology findings, size of the needle, number of needle passes and post procedure complications. All patients were observed for 24 hours post procedure. Bleeding complications were defined using the Common Terminology Criteria for Adverse Events (CTCAE, version 4.0) established by the National Cancer Institute.

Among the 309 percutaneous core biopsies performed during the study period, 147 (47.6%) biopsies were performed using 15 G needles and 162 (52.4%) were using 18G needles. No major complication was noted. 30 patients had post procedure bleeding (9.7%), 26 of which were CTCAE grade 1 (8.4%) and 4 CTCAE grade 2 (1.3%). Complications were slightly less common in patients in whom 18G needle was used but this was not statistically significant (p = 0.37). No significant difference in age, platelet count, coagulation number at the time of biopsy, number of passes, and biopsy in native versus transplant kidney was observed in patients with complications compared with those without complications. Complications were diagnosed in 82% of patients at < or = 2 hours, 99% at < or = 6 hours, and 100% at < or = 8 hours.

In conclusion, when considering percutaneous ultrasound guided core needle biopsy of the kidney observation of 6-8 hours would be sufficient without the risks of missing delayed complications.

Optimum duration for post biopsy observation of percutaneous ultrasound guided core needle kidney biopsy is 6-8 hours.

Yarmohammadi, H, Mortell, K, Hanna, W, Azar, N, Nakamoto, D, Optimum Time of Post Biopsy Observation of Percutaneous Ultrasound-guided Kidney Biopsy Patients.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009958.html