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 core 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 C/D) 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.