Endoscopic ultrasound-guided plugged liver biopsy using a fine-needle biopsy needle and coils in patients with deranged coagulation parameters: proof of concept study for feasibility and safety from India

作者：Biswa Ranjan Patra, S. Gupta, Yash Kallurwar, Chetan Saner, Sidharth Harindranath, Ankita Singh, AB Vaidya, Michael Kuruthukulangara, Jitendra Yadav, Gaurav Lodha, Souradeep Pal, Akash Shukla · 发表于：Clinical Endoscopy · 年份：2025 · DOI：10.5946/ce.2025.188 · 被引用次数：1 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Gallbladder and Bile Duct Disorders、Liver Disease Diagnosis and Treatment

BACKGROUND: Endoscopic ultrasound (EUS)-guided liver biopsy in patients with coagulopathy remains unexplored mainly because of the lack of effective hemostatic techniques in the event of post-biopsy bleeding. This study evaluated the feasibility and safety of a novel technique, EUS-guided plugged liver biopsy (EUS-PLB), which incorporates coil embolization for tract hemostasis. METHODS: In a pilot study, 20 patients with coagulopathy (platelets 20,000-50,000/μL or international normalized ratio 1.5-2.5) underwent EUS-PLB using a modified heparinized wet suction technique. Hemostasis was achieved via real-time EUS-guided deployment of 1 to 2 coils (0.035-inch, 5-cm length, 3-mm diameter coil) into the needle tract. Outcomes included technical and clinical success, sample adequacy, and adverse events. RESULTS: Coil placement was technically successful in all patients. Persistent needle-tract bleeding occurred in five cases and was effectively controlled. The clinical success rate for preventing significant bleeding (early or delayed) was 100%. Adequate biopsy samples were obtained in 18/20 patients (90%), with a mean total specimen length of 3.34±0.88 cm and median complete portal tracts of 18 (range, 6-25). Histological diagnosis was possible in 95% of cases. One patient experienced a mild adverse event (5%). CONCLUSIONS: This novel EUS-PLB technique with coil embolization may offer a safe and effective biopsy solution for patients with coagulopathy and warrants further invest...