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Percutaneous endovascular biopsy of intravascular masses: efficacy and safety in establishing pre-therapy diagnosis

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy and safety of percutaneous endovascular biopsy (PEB) in intravascular filling-defect lesions (IVLs) of the great vessels.

Material and methods

We retrospectively reviewed 19 patients (age 65 ± 12 years), 11 men and eight women, who underwent PEB for IVLs, between March 2004 and November 2014. All PEBs were performed for early diagnosis and/or characterization of the IVL, or in case of reasonable doubt about the IVL nature. Pre-intervention imaging work-up included CT, MRI and/or PET-CT. PEBs were obtained with a 7F biopsy forceps device. Clinical profile, procedure technical success and safety, and clinical success were evaluated.

Results

PEB was technically successful in all patients (mean of two samples per IVL). No intra- or post-procedural complications were reported. Histopathological analysis provided a diagnosis in all PEBs with a clinical success of 100%. Of the 19 IVLs, 14 were malignant (74%). The most frequent malignant lesion observed was leiomyosarcoma (29%). Benign lesions (26%) included three thrombi (pulmonary artery) and two myxomas.

Conclusion

PEB is a safe and efficient procedure providing the most effective technique to obtain a tissue sample of high diagnostic quality, which serves to establish early diagnosis in patients with suspected malignant lesions.

Key Points

• Intravascular filling-defect lesions are related to both benign conditions and malignant tumours.

• Endovascular biopsy is indicated in case of doubt about intravascular lesion nature.

• Percutaneous endovascular biopsy is a safe technique.

• Endovascular biopsy provides tissue samples leading to correct histopathological analysis.

• Percutaneous endovascular biopsy provides early diagnosis of malignant intravascular lesions.

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Authors and Affiliations

  1. Cardiothoracic and Vascular Unit, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Anastasia Pomoni, Charalampos Sotiriadis, Frédérique Gay, Anne-Marie Jouannic & Salah D. Qanadli

Authors
  1. Anastasia Pomoni
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  2. Charalampos Sotiriadis
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  3. Frédérique Gay
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  4. Anne-Marie Jouannic
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  5. Salah D. Qanadli
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Corresponding author

Correspondence to Salah D. Qanadli.

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Guarantor

The scientific guarantor of this publication is Prof. Salah D. Qanadli MD, PhD, FCIRSE.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

One patient’s data have been previously reported in the European Journal of Cardiothoracic Surgery.

Methodology

• retrospective

• performed at one institution

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Pomoni, A., Sotiriadis, C., Gay, F. et al. Percutaneous endovascular biopsy of intravascular masses: efficacy and safety in establishing pre-therapy diagnosis. Eur Radiol 28, 301–307 (2018). https://doi.org/10.1007/s00330-017-4983-9

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  • DOI: https://doi.org/10.1007/s00330-017-4983-9

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