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Assessing the Need for Preprocedural Laboratory Tests and Stopping Non-steroidal Anti-inflammatory Drugs/Aspirin in Patients Undergoing Percutaneous Bone and Soft Tissue Biopsies

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Although image-guided biopsies of bone and soft tissue lesions have a low complication rate, there is limited data evaluating use of preprocedural laboratory tests. To address this issue, patients were not required to stop non-steroidal antiinflammatory drugs (NSAIDs) and aspirin or to obtain preprocedural laboratory tests [complete blood count (CBC) and international normalized ratio (INR)], except in special circumstances. The bleeding complication rate, rate of same day biopsies, and the time from when the biopsy was ordered to when it was performed were obtained.

Materials and Methods

A total of 332 patients who underwent bone or soft tissue biopsies performed at our institution between 9/1/2017 and 1/9/2019 were prospectively analyzed. These data were compared to a retrospective biopsy cohort of 323 patients between 7/1/2015 and 7/1/2017. Data collected included method of image guidance and bleeding complication rate. The number of days from ordering to performing a biopsy and number of same day biopsies were recorded.

Results

There were no bleeding complications in either cohort (OR 1.00, P = 1). The mean time from ordering to performing a bone biopsy was significantly decreased in the prospective group (6.6 days) compared to the retrospective group (8.1 days) (P = 0.012). There were more same day biopsies in the prospective cohort (11.4% vs. 3.4%) (P < 0.001).

Conclusions

Preprocedural CBC and INR for bone and soft tissue biopsies can be safely eliminated in most patients. Biopsies performed while patients are taking NSAIDs/aspirin can safely be performed. Adopting revised preprocedural laboratory criteria can result in decreased time to completion of biopsies.

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Authors and Affiliations

  1. Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Samir D. Mehta, Scott O. Trerotola, Mohammed Nawas, Andrew S. Chi & Ronnie Sebro

  2. Department of Orthopedic Surgery, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, USA

    Kristy Weber & Ronnie Sebro

  3. Department of Anesthesiology and Critical Care, University of Pennsylvania, 3400 Spruce Street, Dulles 680, Philadelphia, PA, 19104, USA

    Lee Fleisher

  4. Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Lawrence N. Shulman

  5. Department of Radiation Oncology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Peter Gabriel

  6. Department of Epidemiology and Biostatistics, University of Pennsylvania, 421 Marie Curie Blvd, Philadelphia, PA, 19104, USA

    Ronnie Sebro

  7. Department of Genetics, University of Pennsylvania, 421 Marie Curie Blvd, Philadelphia, PA, 19104, USA

    Ronnie Sebro

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  1. Samir D. Mehta
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  2. Kristy Weber
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Correspondence to Ronnie Sebro.

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Author S.T. reports royalties for Teleflex and Cook and is a consultant for Adrenas, MedComp, BD Bard, Lutonix, WL Gore, Cook, Teleflex.

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Mehta, S.D., Weber, K., Fleisher, L. et al. Assessing the Need for Preprocedural Laboratory Tests and Stopping Non-steroidal Anti-inflammatory Drugs/Aspirin in Patients Undergoing Percutaneous Bone and Soft Tissue Biopsies. Cardiovasc Intervent Radiol 42, 1588–1596 (2019). https://doi.org/10.1007/s00270-019-02274-x

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  • DOI: https://doi.org/10.1007/s00270-019-02274-x

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