Needle-tract bleeding after percutaneous radiofrequency ablation for hepatocellular carcinomas: risk factors,prevention and treatment
Journal Title: Di-er Junyi Daxue Xuebao - Year 2008, Vol 29, Issue 11
Abstract
Objective:To analyze the risk factors,prevention and treatment of needle-tract bleeding after percutaneous image-guided radiofrequency ablation (PRFA) for hepatocellular carcinomas (HCC).Methods: A total of 1 567 RFA sessions were performed on 1 203 patients with 3 067 focuses of hepatocellular carcinoma between December 1999 and January of 2008.The clinical data of patients suffering from needle-tract bleeding were analyzed for risk factors,prevention,and treatment.Results: Seventeen (1.08%,17/1 567) patients developed needle-tract bleeding.Univariate analysis showed that the incidence of needle-tract bleeding was significantly correlated with the lower platelet count,prolongation of prothrombin time,the degree of liver cirrhosis,subcapsular HCCs and pattern of RF needle electrode (P=0.039; P=0.023; P=0.012; P=0.032 and P=0.016,respectively).Logistic regression model found that only lower platelet count,prolongation of prothrombin time,degree of liver cirrhosis and subcapsular HCCs were the independent risk factors for needle-tract bleeding after PRFA in patients with hepatocellular carcinoma (OR=4.032,P=0.040;OR=5.611,P=0.009;OR=3.871,P=0.046 and OR=5.216,P=0.026,respectively).Of the 17 patients 5 received only medicine therapy in the internal department,4 received surgery and 10 received transcatheter embolization.Thirteen patients survived and 4 died.Conclusion: It is indicated that prolongation of prothrombin time,lower platelet count,sub-capsular HCCs and pattern of RF needle electrode can influence the needle-tract bleeding after PRFA in hepatocellular carcinoma patients.The most effective methods to control the bleeding are transcatheter embolization and DSA or surgery for HCC patients after PRFA.
Authors and Affiliations
Bo ZHAI
Keywords
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