Hemostatic effect of glue-lipiodol mixture plugged in the needle tract after renal biopsies in a high-risk, anticoagulated rabbit model

RATIONALE AND OBJECTIVES. TO investigate the hemostatic effect of a glue-li piodol mixture plugged immediately into the needle tract after renal biopsy of high-risk, anticoagulated rabbits by use of a large-core gun biopsy nee dle and the subsequent pathological changes of the biopsy tract. METHODS. Twenty-five rabbits weighing 2 kg were; divided into five groups ( five rabbits each) according to time of sacrifice at 0, 2, 4, 6, and 8 days after biopsy. After anesthesia was induced, both kidneys were exposed and a bolus of 100 U/kg heparin was administered intravenously. Blood sampling was done twice, once before and once after heparinization, and activated pa rtial thromboplastin times were measured for each. Then renal biopsies were performed in 25 pairs of kidneys by using an 18-gauge automated biopsy gun , The glue-lipiodol mixture was not injected into the first biopsy sites (c ontrol), Immediately after the second biopsies were done, 0.5 mL of the glu e-lipiodol mixture at a 1:3 ratio was plugged into the needle tract through the outer cannula while withdrawing it slowly, Bleeding times of the two b iopsies of each pair of kidneys were measured. All rabbits were humanely ki lled at their previously scheduled times, and histopathological findings we re evaluated for the presence of inflammation, necrosis, foreign body react ion, and fibrosis around the biopsy tract. All parameters mere classified i nto four categories according to the degree of severity, from 0 to +++. RESULTS. Twenty-five cases (100%) of the controls bled after the biopsies w ere performed. Four of them (16%) showed immediate, massive, pulsatile blee ding. In contrast, only 11 of 25 cases (44%) bled at the second biopsy (plu gged) sites and only two of them (8%) showed pulsatile bleeding, Mean bleed ing times were 228 seconds in controls and 26 seconds in the glue-lipiodol mixture-plugged sites (P < 0.000). Histopathological examination of the nee dle tract in the plugged group revealed mild inflammation in the 0- to 2-da y groups and moderate inflammation and mild necrosis in the 4- and 6-day gr oups, In the 8-day group, inflammation was diminished and only mild fibrosi s,vas noted. There was no foreign body reaction in any of the specimens of the plugged group. CONCLUSIONS. We conclude that a glue-lipiodol mixture, when used as a plug material for the renal biopsy tract, is an efficacious method of bleeding c ontrol that is associated with a low incidence of pathological alterations in an anticoagulated rabbit model, thus demonstrating its future potential for clinical application.