TRANSFEMORAL LIVER-BIOPSY BY FORCEPS - A REVIEW OF 104 CONSECUTIVE PROCEDURES

Purpose: Transvenous liver biopsy is performed on patients with contra indications to percutaneous biopsy. Transfemoral liver biopsy has not been widely reported, and we present our experience of 104 consecutive procedures. Methods: During a 30-month period, 88 patients underwent 104 transfemoral liver biopsies. Under fluoroscopic guidance a 9 Fr cu rved introducer catheter is passed into the right hepatic vein via a s tandard femoral sheath. A 7 Fr biopsy forceps is then passed into the liver, opened and wedged. Prior to biopsy, the image intensifier is ro tated so the relation of the capsular surface to the biopsy site is ve rified and capsular perforation avoided. Results: Tissue samples obtai ned in 97 of 104 procedures (93%) were adequate for diagnosis in 83 (8 0%). Complications occurred in six procedures (6%) including two capsu lar perforations; the latter two were treated by coil embolization. Co nclusion: We found transfemoral liver biopsy using forceps to be a saf e, well-tolerated procedure with a high diagnostic yield and it is a t echnically easy alternative to the transjugular approach using large n eedles.