Transjugular Liver Biopsy via the Left Internal Jugular Vein
Purpose To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach. Materials and methods A retrospective review of all TJLBs performed at one institution was performed. From August 1995 to October 2004, 293 liver bio...
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Published in | Journal of vascular and interventional radiology Vol. 18; no. 2; pp. 237 - 241 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Inc
01.02.2007
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Abstract | Purpose To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach. Materials and methods A retrospective review of all TJLBs performed at one institution was performed. From August 1995 to October 2004, 293 liver biopsies were performed. Nineteen of the 293 procedures (6.5%) were performed from the left IJV in 17 patients. There were 11 men and six women aged 36–59 years (mean, 49.3 years). All patients were suspected of having diffuse hepatic parenchymal disease and had contraindications to conventional percutaneous liver biopsy. The stiff metal biopsy cannula was advanced across the mediastinum and through the heart over a stiff guide wire. Biopsy was performed from the right hepatic vein in 15 procedures, the middle hepatic vein in two, and the intrahepatic IVC in two. Results The indications for using the left IJV approach were nonusable right IJV in 12 procedures, difficult previous catheterization of the hepatic veins from the right IJV due to distorted hepatic anatomy in six procedures, and the operator’s predilection for this approach in one procedure (the patient had previously undergone liver transplantation). All biopsies were successful, with diagnostic tissue obtained in 100% of cases. Two patients had chest pain during the procedure associated with placement of the rigid cannula through the mediastinal veins. One patient had a vaso-vagal episode that necessitated the use of intravenous atropine but subsequently underwent successful biopsy. All episodes of chest pain resolved after the cannula was removed. There were no recorded hemorrhagic or cardiac complications. Conclusion TJLB can be safely and repeatedly performed from the left IJV when the right IJV is not available or the hepatic anatomy prevents catheterization of the hepatic veins from the right IJV. |
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AbstractList | To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach.
A retrospective review of all TJLBs performed at one institution was performed. From August 1995 to October 2004, 293 liver biopsies were performed. Nineteen of the 293 procedures (6.5%) were performed from the left IJV in 17 patients. There were 11 men and six women aged 36-59 years (mean, 49.3 years). All patients were suspected of having diffuse hepatic parenchymal disease and had contraindications to conventional percutaneous liver biopsy. The stiff metal biopsy cannula was advanced across the mediastinum and through the heart over a stiff guide wire. Biopsy was performed from the right hepatic vein in 15 procedures, the middle hepatic vein in two, and the intrahepatic IVC in two.
The indications for using the left IJV approach were nonusable right IJV in 12 procedures, difficult previous catheterization of the hepatic veins from the right IJV due to distorted hepatic anatomy in six procedures, and the operator's predilection for this approach in one procedure (the patient had previously undergone liver transplantation). All biopsies were successful, with diagnostic tissue obtained in 100% of cases. Two patients had chest pain during the procedure associated with placement of the rigid cannula through the mediastinal veins. One patient had a vaso-vagal episode that necessitated the use of intravenous atropine but subsequently underwent successful biopsy. All episodes of chest pain resolved after the cannula was removed. There were no recorded hemorrhagic or cardiac complications.
TJLB can be safely and repeatedly performed from the left IJV when the right IJV is not available or the hepatic anatomy prevents catheterization of the hepatic veins from the right IJV. Purpose To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach. Materials and methods A retrospective review of all TJLBs performed at one institution was performed. From August 1995 to October 2004, 293 liver biopsies were performed. Nineteen of the 293 procedures (6.5%) were performed from the left IJV in 17 patients. There were 11 men and six women aged 36–59 years (mean, 49.3 years). All patients were suspected of having diffuse hepatic parenchymal disease and had contraindications to conventional percutaneous liver biopsy. The stiff metal biopsy cannula was advanced across the mediastinum and through the heart over a stiff guide wire. Biopsy was performed from the right hepatic vein in 15 procedures, the middle hepatic vein in two, and the intrahepatic IVC in two. Results The indications for using the left IJV approach were nonusable right IJV in 12 procedures, difficult previous catheterization of the hepatic veins from the right IJV due to distorted hepatic anatomy in six procedures, and the operator’s predilection for this approach in one procedure (the patient had previously undergone liver transplantation). All biopsies were successful, with diagnostic tissue obtained in 100% of cases. Two patients had chest pain during the procedure associated with placement of the rigid cannula through the mediastinal veins. One patient had a vaso-vagal episode that necessitated the use of intravenous atropine but subsequently underwent successful biopsy. All episodes of chest pain resolved after the cannula was removed. There were no recorded hemorrhagic or cardiac complications. Conclusion TJLB can be safely and repeatedly performed from the left IJV when the right IJV is not available or the hepatic anatomy prevents catheterization of the hepatic veins from the right IJV. PURPOSETo retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach.MATERIALS AND METHODSA retrospective review of all TJLBs performed at one institution was performed. From August 1995 to October 2004, 293 liver biopsies were performed. Nineteen of the 293 procedures (6.5%) were performed from the left IJV in 17 patients. There were 11 men and six women aged 36-59 years (mean, 49.3 years). All patients were suspected of having diffuse hepatic parenchymal disease and had contraindications to conventional percutaneous liver biopsy. The stiff metal biopsy cannula was advanced across the mediastinum and through the heart over a stiff guide wire. Biopsy was performed from the right hepatic vein in 15 procedures, the middle hepatic vein in two, and the intrahepatic IVC in two.RESULTSThe indications for using the left IJV approach were nonusable right IJV in 12 procedures, difficult previous catheterization of the hepatic veins from the right IJV due to distorted hepatic anatomy in six procedures, and the operator's predilection for this approach in one procedure (the patient had previously undergone liver transplantation). All biopsies were successful, with diagnostic tissue obtained in 100% of cases. Two patients had chest pain during the procedure associated with placement of the rigid cannula through the mediastinal veins. One patient had a vaso-vagal episode that necessitated the use of intravenous atropine but subsequently underwent successful biopsy. All episodes of chest pain resolved after the cannula was removed. There were no recorded hemorrhagic or cardiac complications.CONCLUSIONTJLB can be safely and repeatedly performed from the left IJV when the right IJV is not available or the hepatic anatomy prevents catheterization of the hepatic veins from the right IJV. |
Author | Lakin, Paul, MD Barton, Robert E., MD Keller, Frederick S., MD Yavuz, Kivilcim, MD Petersen, Bryan, MD Kaufman, John A., MD Geyik, Serdar, MD |
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Cites_doi | 10.1016/S1051-0443(91)72244-6 10.1016/S1051-0443(99)70119-3 10.1056/NEJM197308022890501 10.1148/radiology.204.2.9240522 10.1148/radiology.157.3.4059543 10.1148/radiology.148.1.6856856 10.1016/S0009-9260(05)80004-2 10.1016/S1051-0443(96)70748-0 10.1002/hep.1840150429 |
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Keywords | IJV internal jugular vein, IVC = inferior vena cava, TJLB = transjugular liver biopsy |
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References_xml | – volume: 148 start-page: 306 year: 1983 ident: bib3 article-title: Liver biopsy through the transjugular approach: modification of instruments publication-title: Radiology contributor: fullname: Blendis – volume: 45 start-page: 238 year: 1992 end-page: 239 ident: bib5 article-title: Transjugular liver biopsy: a review of 200 biopsies publication-title: Clin Radiol contributor: fullname: Davey – volume: 7 start-page: 127 year: 1996 end-page: 131 ident: bib6 article-title: Transjugular liver biopsy: a prospective study in 43 patients with the quick-core biopsy needle publication-title: J Vasc Interv Radiol contributor: fullname: Orons – volume: 289 start-page: 227 year: 1973 end-page: 231 ident: bib1 article-title: Transjugular approach to liver biopsy and transhepatic cholangiography publication-title: N Engl J Med contributor: fullname: Dotter – volume: 204 start-page: 369 year: 1997 end-page: 372 ident: bib8 article-title: Transjugular liver biopsy with an automated device publication-title: Radiology contributor: fullname: Rymer – volume: 2 start-page: 563 year: 1991 end-page: 564 ident: bib4 article-title: Use of a guard wire during transjugular liver biopsy with the colapinto needle publication-title: J Vasc Interv Radiol contributor: fullname: Osterman – volume: 10 start-page: 807 year: 1999 end-page: 809 ident: bib9 article-title: Improved method for transjugular liver biopsy publication-title: J Vasc Interv Radiol contributor: fullname: Galati – volume: 157 start-page: 589 year: 1985 end-page: 593 ident: bib2 article-title: Transjugular liver biopsy: a review of 461 biopsies publication-title: Radiology contributor: fullname: Blendis – volume: 15 start-page: 726 year: 1992 end-page: 732 ident: bib7 article-title: Transjugular liver biopsy publication-title: Hepatology contributor: fullname: Rosch – volume: 2 start-page: 563 year: 1991 ident: 10.1016/j.jvir.2006.12.730_bib4 article-title: Use of a guard wire during transjugular liver biopsy with the colapinto needle publication-title: J Vasc Interv Radiol doi: 10.1016/S1051-0443(91)72244-6 contributor: fullname: Trerotola – volume: 10 start-page: 807 year: 1999 ident: 10.1016/j.jvir.2006.12.730_bib9 article-title: Improved method for transjugular liver biopsy publication-title: J Vasc Interv Radiol doi: 10.1016/S1051-0443(99)70119-3 contributor: fullname: Middlebrook – volume: 289 start-page: 227 year: 1973 ident: 10.1016/j.jvir.2006.12.730_bib1 article-title: Transjugular approach to liver biopsy and transhepatic cholangiography publication-title: N Engl J Med doi: 10.1056/NEJM197308022890501 contributor: fullname: Rosch – volume: 204 start-page: 369 year: 1997 ident: 10.1016/j.jvir.2006.12.730_bib8 article-title: Transjugular liver biopsy with an automated device publication-title: Radiology doi: 10.1148/radiology.204.2.9240522 contributor: fullname: Kardache – volume: 157 start-page: 589 year: 1985 ident: 10.1016/j.jvir.2006.12.730_bib2 article-title: Transjugular liver biopsy: a review of 461 biopsies publication-title: Radiology doi: 10.1148/radiology.157.3.4059543 contributor: fullname: Gamble – volume: 148 start-page: 306 year: 1983 ident: 10.1016/j.jvir.2006.12.730_bib3 article-title: Liver biopsy through the transjugular approach: modification of instruments publication-title: Radiology doi: 10.1148/radiology.148.1.6856856 contributor: fullname: Colapinto – volume: 45 start-page: 238 year: 1992 ident: 10.1016/j.jvir.2006.12.730_bib5 article-title: Transjugular liver biopsy: a review of 200 biopsies publication-title: Clin Radiol doi: 10.1016/S0009-9260(05)80004-2 contributor: fullname: Corr – volume: 7 start-page: 127 year: 1996 ident: 10.1016/j.jvir.2006.12.730_bib6 article-title: Transjugular liver biopsy: a prospective study in 43 patients with the quick-core biopsy needle publication-title: J Vasc Interv Radiol doi: 10.1016/S1051-0443(96)70748-0 contributor: fullname: Little – volume: 15 start-page: 726 year: 1992 ident: 10.1016/j.jvir.2006.12.730_bib7 article-title: Transjugular liver biopsy publication-title: Hepatology doi: 10.1002/hep.1840150429 contributor: fullname: McAfee |
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Snippet | Purpose To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach.... To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach. A retrospective... PURPOSETo retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach.MATERIALS... |
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SubjectTerms | Adult Biopsy, Needle - methods Female Hepatic Veins Humans Jugular Veins Liver - pathology Liver Diseases - diagnosis Male Middle Aged Radiology Retrospective Studies |
Title | Transjugular Liver Biopsy via the Left Internal Jugular Vein |
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