Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions - results of the prospective multicenter DEGUM interventional ultrasound study (PIUS study)

Strobel D, Bernatik T, Blank W, Will U, Reichel A, Wuestner M, Keim V, Schacherer D, Barreiros AP, Kunze G, Nuernberg D, Ignee A, Burmester E, Bunk AA, Friedrich-Rust M, Froehlich E, Schuler A, Jenssen C, Bohle W, Mauch M, Dirks K, Kaemmer J, Pachmann C, Stock J, Hocke M, Kendel A, Schmidt C, Jakobeit C, Kinkel H, Heinz W, Huebner G, Pichler M, Mueller T (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Book Volume: 36

Pages Range: 122-31

Journal Issue: 2

DOI: 10.1055/s-0034-1399282

Abstract

To analyse the incidence of bleeding after percutaneous ultrasound guided diagnostic and therapeutic intraabdominal interventions in a prospective multicentre study (DEGUM percutaneous interventional ultrasound study).Within a time period of 2 years diagnostic and therapeutic intraabdominal interventions (with the exclusion of ascites paracentesis) performed percutaneously under continuous ultrasound (US) guidance were prospectively assessed using a pseudonymized standardized web site entry form. Number and type of intervention, operator experience, patient characteristics, medication, lab data as well as technical aspects of the procedure and bleeding complications were analysed according to the interventional radiology standards.8172 US-guided intraabdominal interventions (liver n = 5903; pancreas n = 501, kidney n = 434, lymph node = 272, biliary system n = 153, spleen n = 63, other abdominal organs and extra-organic targets n = 999) were analysed in 30 hospitals. The majority were diagnostic biopsies including 1780 liver parenchyma, 3400 focal liver lesions and 404 pancreatic lesions. 7525 interventions (92.1 %) were performed in hospitalized patients (mean age 62.6 years). Most operators were highly experienced in US-guided interventions (> 500 interventions prior to the study n = 5729; 70.1 %). Sedation was administered in 1131 patients (13.8 %). Needle diameter was >= 1 mm in 7162 punctures (87.9 %) with main focus on core needle biopsies (18 G, n = 4185). Clinically relevant bleeding complications with need of transfusion (0.4 %), surgical bleeding control (0.1 %) and radiological coiling (0.05 %) were very rare. Bleeding complications with fatal outcome occurred in four patients (0.05 %). The frequency of major bleeding complications was significantly higher in patients with an INR > 1.5 (p < 0.001) and patients taking a medication potentially interfering with platelet function or plasmatic coagulation (p < 0.0333).This prospective multicentre study confirms the broad spectrum of percutaneous US-guided intraabdominal interventions. However diagnostic liver biopsies dominate with the use of core needle biopsies (18 G). Percutaneous US-guided interventions performed by experienced sonographers are associated with a low bleeding risk. Major bleeding complications are very rare. A pre-interventional INR < 1.5 and individual medication risk assessment are recommended.

Authors with CRIS profile

Additional Organisation(s)

Involved external institutions

Caritas-Krankenhaus Bad Mergentheim gemeinnützige GmbH Germany (DE) Ruppiner Kliniken Germany (DE) Schwarzwald-Baar Klinikum Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Universitätsklinikum Regensburg Germany (DE) Universitätsklinikum Leipzig Germany (DE) Krankenhaus der Barmherzigen Brüder Trier Germany (DE) SRH Wald-Klinikum Gera Germany (DE) Klinikum am Steinenberg Reutlingen Germany (DE) Kreisklinik Ebersberg Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) HELIOS Kliniken Germany (DE) Klinikverbund Südwest (Sindelfingen-Böblingen, Calw, Nagold, Leonberg, Herrenberg) Germany (DE) Krankenhaus Düren GmbH Germany (DE) Albertinen-Krankenhaus Germany (DE) Kreiskrankenhaus Gummersbach Germany (DE) Vivantes - Netzwerk für Gesundheit GmbH Germany (DE) Israelitisches Krankenhaus Hamburg Germany (DE) Alexianer St. Hedwig Kliniken Berlin GmbH Germany (DE) Rems-Murr-Kliniken Germany (DE) SRH Kreiskrankenhaus Sigmaringen Germany (DE) Katharinenhospital Stuttgart Germany (DE) Krankenhaus Märkisch Oderland Germany (DE) Alb Fils Kliniken Germany (DE) Karl-Olga-Krankenhaus Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Sana Kliniken Lübeck GmbH Germany (DE)

How to cite

APA:

Strobel, D., Bernatik, T., Blank, W., Will, U., Reichel, A., Wuestner, M.,... Mueller, T. (2015). Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions - results of the prospective multicenter DEGUM interventional ultrasound study (PIUS study). Ultraschall in der Medizin, 36(2), 122-31. https://doi.org/10.1055/s-0034-1399282

MLA:

Strobel, Deike, et al. "Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions - results of the prospective multicenter DEGUM interventional ultrasound study (PIUS study)." Ultraschall in der Medizin 36.2 (2015): 122-31.

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