Percutaneous Renal Biopsies and Hemorrhage in Multiple Myeloma Michelle Rodgers, M.D., Reagan G. Baber, William C. Culp, M.D., Richard R. Reinholtz, M.D., W. Jean Matchett, M.D., Timothy C. McCowan, M.D. [view full presentation poster]*

Purpose

Background

Methods

Results

Discussion

• All patients getting renal biopsies, either with or without MM, are likely to have bleeding problems. This is the primary risk of this procedure and makes correction of the coagulation factors most important prior to biopsy.
• Precision of needle placement does make a difference.
• All categories tend toward more bleeding with MM than in non-MM.
• Central biopsies (where larger vessels are encountered) show an increased bleeding tendency.
• Safest MM group is the Tangential biopsy group.
• Safest group of all is non-MM Tangential biopsy group which is signifi cantly safer than MM.
• Alternative techniques including transjugular venous and blunt tipped needle techniques have been reported and might be worth developing for very high risk patients.

Conclusion

• Renal biopsies in multiple myeloma tend to bleed more often and to a greater extent than non-MM cases.
• Tangential biopsy in non-MM patients causes statistically less bleeding than in MM patients.
• CT guided tangential needle placement is precise, tends to produce less bleeding, and should be the standard approach for renal biopsy, especially in high risk patients.

References

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