Safety of Percutaneous Biopsy for Hepatic Angiosarcoma: Results of a Multicenter Korean Survey

Purpose: To evaluate the incidence of severe bleeding and mortality associated with percutaneous biopsy for hepatic angiosarcoma in a multicenter retrospective cohort. Materials and Methods: A retrospective review of 33 patients with biopsy-proven hepatic angiosarcoma (29 male; median age, 57 y; age range, 24-96 y) was performed at seven tertiary academic hospitals between January 1998 and March 2015. The mean maximum tumor size was 5.5 cm (range, 1.7-20 cm). An 18-gauge automated cutting biopsy needle was used with a freehand technique in all patients who underwent ultrasonography-guided percutaneous cote needle biopsy on an inpatient basis. The incidences of severe bleeding and procedure-related mortality were evaluated per Society of Interventional Radiology (SIR) guidelines. Results: There was a mean of 2.8 needle passes per patient during the procedure (range, 1-6). The overall incidence of severe bleeding events (SIR grade CAD) was 9.1% (3 of 33). Two patients were managed with blood transfusion, and one patient; underwent embolization for bleeding control. No other major complications were encountered. There were no cases of mortality associated with the biopsy. Conclusions: Severe bleeding was not a frequent complication after percutaneous biopsy for hepatic angiosarcoma. The majority of bleeding complications could be controlled with conservative management.