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Eur Radiol. 2018 Jan;28(1):301-307. doi: 10.1007/s00330-017-4983-9. Epub 2017 Aug 4.

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

Author information

1
Cardiothoracic and Vascular Unit, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
2
Cardiothoracic and Vascular Unit, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland. salah.qanadli@chuv.ch.

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.

KEYWORDS:

Angiography; Early diagnosis; Endovascular biopsy; Intravascular filling-defect; Sarcoma

PMID:
28779399
DOI:
10.1007/s00330-017-4983-9
[Indexed for MEDLINE]

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