Rathod K R, Popat B A, Pandey A, Jamale T E, Hase N K, Deshmukh H L
Department of Radiology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Department of Nephrology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Indian J Nephrol. 2017 Mar-Apr;27(2):118-123. doi: 10.4103/0971-4065.196932.
Although percutaneous renal biopsy remains the preferred method, there are several scenarios where transjugular approach is more suitable. We hereby describe our technique of transjugular renal biopsy (TJRB) and evaluate its safety and efficacy. We retrospectively collected data regarding indication for the transjugular route of biopsy, its complications, clinical and laboratory data, and adequacy of samples from patients' records. TJRB was performed when the patients were at a high risk for bleeding from percutaneous renal biopsy. Tissue samples were assessed by a pathologist for adequacy. All patients were followed up with ultrasonographic scan 3 h after the procedure and on day 3. Nine patients (age 41.5 ± 15.4 years; 8 men) underwent 9 TJRB procedures. The procedure was technically successful in all patients. Six patients (66.67%) had a platelet count of <50,000/mcL, 2 (33.3%) had an elevated International Normalized Ratio of more than 1.4, and 1 had both. 3.2 ± 0.4 cores were obtained, with median (range) number of glomeruli being ten (7-11). Adequate renal tissue sample was obtained in all the patients. Though capsular perforation developed in 5 patients, none had major complication requiring management (endovascular treatment or blood transfusion). TJRB is a safe and effective in patients with contraindications to percutaneous biopsy.
尽管经皮肾活检仍是首选方法,但在某些情况下,经颈静脉途径更为合适。我们在此描述经颈静脉肾活检(TJRB)技术,并评估其安全性和有效性。我们回顾性收集了患者记录中关于经颈静脉活检途径的适应证、并发症、临床和实验室数据以及样本充足性的数据。当患者经皮肾活检出血风险较高时,进行TJRB。组织样本由病理学家评估其充足性。所有患者在术后3小时和第3天接受超声扫描随访。9例患者(年龄41.5±15.4岁;8例男性)接受了9次TJRB手术。所有患者手术技术均成功。6例患者(66.67%)血小板计数<50,000/μL,2例(33.3%)国际标准化比值升高超过1.4,1例两者兼有。获取了3.2±0.4个肾组织条,肾小球中位数(范围)为10个(7 - 11个)。所有患者均获得了足够的肾组织样本。尽管5例患者发生了包膜穿孔,但均无需要处理的重大并发症(血管内治疗或输血)。TJRB对经皮活检有禁忌证的患者是安全有效的。