RENAL BIOPSY WITH FORCEPS THROUGH THE FEMORAL VEIN

PURPOSE: To evaluate the usefulness of a new technique of transvascula r renal biopsy with a flexible forceps in high-risk patients and compa re its results with those reported for other techniques of renal biops y, PATIENTS AND METHODS: Sixteen transfemoral renal biopsies were perf ormed in 13 high-risk patients, Indications included severe bleeding d isorders, combined renal-hepatic biopsy, morbid obesity, solitary kidn ey, and poor clinical condition, The technique was performed through t he femoral vein; a 7-F Mullins introducer sheath was placed in a subco rtical renal vein, and the biopsy was performed with a flexible biopsy forceps, RESULTS: Renal tissue was obtained in 15 of 16 procedures (9 3.7%) with at least one glomerulus in 14 of 16 (87.5%), and at least s ix glomeruli in 11 of 16 procedures (69%), Samples adequate for diagno sis were obtained in 13 of 16 procedures (81%), Mean number of glomeru li per procedure was 12.6 (range, 0-39), Aside from transient hematuri a in two patients, no other complications were known to have occurred, CONCLUSIONS: Transfemoral renal biopsy is a safe technique for acquis ition of renal samples in high-risk patients, The procedure can be per formed at the same time as other vascular techniques, The histopatholo gic results, although worse than those obtained with the percutaneous approach, are better than those reported with other transvascular tech niques.