Transjugular liver biopsy: assessment of safety and efficacy of the Quick-Core biopsy needle

Abstract

Background: We assessed the safety and efficacy of transjugular liver biopsy with the Quick-Core biopsy needle.

Methods: Fifty consecutive patients with liver failure and contraindications to percutaneous liver biopsy were referred for transjugular liver biopsy. Eighteen (36%) patients had thrombocytopenia (platelet range = 44–92/μL, mean = 66/μL), 31 (62%) patients had elevated prothrombin times (international normalized ratio range = 1.3–3, mean = 1.6), and 19 (38%) patients had ascites. The Cook Quick-Core biopsy needle was used.

Results: Average procedure time was 30 min. Transjugular access to the hepatic veins was successful in 49 of 50 cases. A transfemoral approach was used in one patient. Tissue specimens were satisfactory for histologic diagnosis in all cases. Established cirrhosis was present in 37 (74%) patients. The mean number of cores was 2.2 (range = 1–3). The mean number of portal triads per core was 10.4 (range = 6–20). There were no procedure-related complications.

Conclusion: Transjugular liver biopsy with the Quick-Core biopsy needle is safe and effective in patients in whom the percutaneous route is contraindicated by coagulopathy or ascites.