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Tytuł:
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Experience with Compressed Gelfoam Plugs in Children during Liver Biopsies and Other IR Procedures: A Retrospective Single-Center Case Series.
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Autorzy:
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McDonald J; Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada; University of Edinburgh Medical School, Edinburgh, United Kingdom. Electronic address: .
Amirabadi A; Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Farhat Z; Department of Diagnostic Imaging, IWK Health Centre, Dalhousie University Faculty of Medicine, Halifax, Canada.
Temple M; Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Parra D; Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Amaral J; Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Connolly B; Department of Diagnostic Imaging, Division of Image Guided Therapy, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
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Źródło:
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Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2019 Nov; Vol. 30 (11), pp. 1855-1862. Date of Electronic Publication: 2019 Jun 13.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Reston, Va. : Society of Cardiovascular and Interventional Radiology, c1990-
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MeSH Terms:
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Image-Guided Biopsy*/adverse effects
Radiography, Interventional*/adverse effects
Gelatin Sponge, Absorbable/*administration & dosage
Hemorrhage/*prevention & control
Liver Diseases/*pathology
Adolescent ; Age Factors ; Anaphylaxis/chemically induced ; Biopsy, Large-Core Needle ; Child ; Child, Preschool ; Female ; Gelatin Sponge, Absorbable/adverse effects ; Hemorrhage/etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Ontario ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Outcome
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Entry Date(s):
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Date Created: 20190617 Date Completed: 20200302 Latest Revision: 20200302
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Update Code:
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20240105
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DOI:
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10.1016/j.jvir.2019.04.004
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PMID:
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31202680
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Purpose: To analyze the experience using compressed gelfoam plugs (CGPs) in children during liver biopsies and other interventional procedures.
Materials and Methods: This was a single-center, retrospective, consecutive case series of 477 various pediatric interventional radiology procedures using CGPs (January 2012 to December 2016) performed on 397 children (209 males, 188 females; median age, 7 years [range, 9 days-17.8 years]; median weight, 18 kg [range, 2.7-141 kg]). Of 477 procedures, most (n = 371) were liver biopsies, 98 were biopsies of other organs, and 8 were non-biopsy procedures. Analysis focused on liver biopsies.
Results: Of liver biopsies, a median of 2 CGPs were used per procedure, and the mean drop in hemoglobin was -0.36 g/dl (-3.0% change). Thirty-seven mild, 8 moderate, 2 severe, and 1 life-threatening (an anaphylaxis to CGP) adverse events (AEs) occurred. Analysis of liver biopsies with AEs showed significant association between number of passes, cores, and focal-type lesions (unadjusted logistic regression: P = .007, P = .022, P = .028, respectively) and age, weight, and number of passes (adjusted multiple logistic regression: P = .006, P = .032, P = .046, respectively). Technical problems relating to CGP deployment were noted in 5 (1%), without any AEs.
Conclusions: CGPs were used in a wide variety of procedures and organs in children. There was 1 life-threatening AE resulting from the rare risk of anaphylaxis caused by the gelfoam-containing plug. After liver biopsies, transfusion was required in 2/371 (0.5%) procedures, 1 related to pre-biopsy anemia (0.25%).
(Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)
