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Title: ON TABLE CT GUIDED GLUE INJECTION TO CONTROL INTRA PROCEDURAL BLEEDING IN HIGH RISK BIOPSY CASE.
e-poster Number: EPOS 54
Category: e Poster
Author Name: Dr. Chirag Kurane
Institute:
Co-Author Name:
Abstract :
Aims & Objectives:
This case study aims to describe the management of intra-procedural bleed during a CT-guided biopsy of a pancreatic carcinoma in a peripheral Interventional Radiology (IR) centre. Pancreatic tumours are challenging to biopsy due to their vascularity and location, and complications such as bleeding can be difficult to manage. This report highlights the on-table use of glue injection via the biopsy needle to control bleeding, showcasing a novel approach in a non-tertiary setting.
Methods:
A 58-year-old male patient underwent a CT-guided biopsy of a pancreatic head necrotic mass encasing the patent superior mesenteric artery and its middle colic and ileocolic branches. During the biopsy, brisk arterial flow occurred through coaxial needle, raising concern for an artery puncture. The glue/lipiodol (1:1 ratio) was prepared. The mixture was injected through the coaxial needle while the latter remained in its position and while it was being withdrawn to achieve track sealing. CT angiography revealed a hyperdense-embolic material in the course of the coaxial throughout the lumen of the proximal part of middle colic and the right sided ileocolic branch. Importantly, no contrast extravasation or additional complications were noted.
Results:
Following the glue injection, immediate cessation of bleeding was observed. The patient’s hemodynamics remained stabilized without further intervention, and no additional bleeding complications were noted on follow-up imaging. Histopathological analysis confirmed the diagnosis of pancreatic adenocarcinoma and was managed further with a treatment plan for pancreatic carcinoma.
Conclusions:
This case demonstrates that CT-guided glue injection through a biopsy needle is a feasible and effective method to control intra-procedural bleeding in high-risk biopsy cases, even in a peripheral IR centre. Such innovative on-table interventions highlight the potential for effective management of complications in non-tertiary settings, emphasizing the need for adaptable techniques and preparedness among interventional radiologists in peripheral centres.
