Treatment of an extracapsular post-renal biopsy pseudoaneurysm with ultrasound-guided thrombin injection

Ultrasound-Guided Thrombin Injection for the Treatment of Bleeding Following Kidney and Liver Biopsies

The purpose of this study was to describe the technique and outcomes of percutaneous thrombin injection into the superficial aspect of actively bleeding liver and kidney biopsy tracks identified with color Doppler ultrasound with the aim of hemorrhage termination. After percutaneous thrombin injection, 15/16 (94%) patients did not require further intervention. Ultrasound-guided thrombin injection into the superficial site of active bleeding is an effective technique for terminating bleeding in the immediate post-procedure period following kidney and liver biopsies and should be considered if active bleeding persists on color Doppler after ≥30 minutes of compression and observation.

Incidental renal artery pseudoaneurysm after percutaneous native renal biopsy

Renal artery pseudoaneurysm (RAP) is an uncommon but potentially life-threatening condition that is often difficult to diagnose. Rarely, it can occur as a complication associated with a percutaneous renal biopsy procedure. The clinical manifestations vary from asymptomatic lesions found incidentally on imaging studies to a mass causing high blood pressure, pain, haematuria and rupture. Although the risk of rupture is considered low, RAP is associated with a high death rate if ruptured. Currently, with the aid of high-quality interventional radiology, this challenging pathology can be effectively treated. In this report, we describe a case of RAP that was incidentally discovered 4 years after percutaneous renal biopsy which was successfully treated with selective angiographic embolisation.