Percutaneous endovascular biopsy of intravascular masses: efficacy and safety in establishing pre-therapy diagnosis
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To evaluate the efficacy and safety of percutaneous endovascular biopsy (PEB) in intravascular filling-defect lesions (IVLs) of the great vessels.
Material and methods
We retrospectively reviewed 19 patients (age 65 ± 12 years), 11 men and eight women, who underwent PEB for IVLs, between March 2004 and November 2014. All PEBs were performed for early diagnosis and/or characterization of the IVL, or in case of reasonable doubt about the IVL nature. Pre-intervention imaging work-up included CT, MRI and/or PET-CT. PEBs were obtained with a 7F biopsy forceps device. Clinical profile, procedure technical success and safety, and clinical success were evaluated.
PEB was technically successful in all patients (mean of two samples per IVL). No intra- or post-procedural complications were reported. Histopathological analysis provided a diagnosis in all PEBs with a clinical success of 100%. Of the 19 IVLs, 14 were malignant (74%). The most frequent malignant lesion observed was leiomyosarcoma (29%). Benign lesions (26%) included three thrombi (pulmonary artery) and two myxomas.
PEB is a safe and efficient procedure providing the most effective technique to obtain a tissue sample of high diagnostic quality, which serves to establish early diagnosis in patients with suspected malignant lesions.
• Intravascular filling-defect lesions are related to both benign conditions and malignant tumours.
• Endovascular biopsy is indicated in case of doubt about intravascular lesion nature.
• Percutaneous endovascular biopsy is a safe technique.
• Endovascular biopsy provides tissue samples leading to correct histopathological analysis.
• Percutaneous endovascular biopsy provides early diagnosis of malignant intravascular lesions.
KeywordsAngiography Intravascular filling-defect Endovascular biopsy Early diagnosis Sarcoma
Compliance with ethical standards
The scientific guarantor of this publication is Prof. Salah D. Qanadli MD, PhD, FCIRSE.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
The authors state that this work has not received any funding.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
Study subjects or cohorts overlap
One patient’s data have been previously reported in the European Journal of Cardiothoracic Surgery.
• performed at one institution