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Purpose: The compare the performance and ability to obtain a correct diagnosis on needle biopsy between 11 gauge and 8 gauge vacuum assisted biopsy devices., Materials and Methods: Hospital records of all consecutive stereotactic core biopsies performed over five years were retrospectively reviewed in compliance Health Insurance Portability and Accountability Act (HIPPA) policy and with approval from the hospital institutional review board (IRB). Pathology from core biopsy was compared with surgical pathology and/or imaging follow-up. A histological underestimation was defined if the surgical excision yielded a higher grade on pathology which changed management., Results: 828 needle core biopsies (47.5%, 393/828 with 11 gauge and 52.5%, 435/828 with 8 gauge) yielded 471 benign, 153 high risk and 204 malignant lesions. 30/193 (15.5%) 11 gauge lesions and 16/185 (8.6%) 8 gauge lesions demonstrated higher grade pathology on surgical excision. The difference in the rates of the number of correct diagnoses on core needle biopsy between 11 gauge (363/393, 92.4%) and 8 gauge (419/435, 96.3%) based on either surgical or clinical/imaging follow up and the difference in the number of discordant benign core biopsies between 11 (17/217, 7.8%) and 8 gauge (4/254, 1.6%) necessitating a surgical biopsy was significant (P=0.013; P=0.001). Although there were more underestimations with the 11 gauge (25/193, 13.0%) than 8 gauge (15/185, 8.1%) needle, this was not significant., Conclusion: Our study demonstrates improved performance and increased diagnostic ability of 8 gauge needle over 11 gauge in obtaining a correct diagnosis on needle biopsy., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: To determine the incidence and risk factors associated with needle tract seeding after percutaneous microwave ablation (MWA) of liver cancer under ultrasound guidance., Materials and Methods: Over a 14-year period, a total of 1462 patients with 2530 malignant nodules were treated by MWA. The influence of age, sex, Child-pugh classification, tumor size, tumor position, previous biopsy, insertion number and antenna type on the risk of neoplastic seeding was assessed. The survival of seeding patients after the MWA was analyzed., Results: Eleven patients with 12 nodules (0.47% per tumor, 0.75% per patient) were identified with needle tract seeding with an interval time of 6-37 (median 10) months after MWA. The mean size of the seeding nodule was 2.3 ± 0.7 cm (from 1.3 to 3.9 cm). Only previous biopsy was significantly associated with neoplastic seeding (P=0.02). All the seeding lesions were successfully treated by resection, MWA, radiation or high intensity focus ultrasound. The median survival period of the 11 patients after the MWA was 36.0 months. The cumulative survival rates of the 11 patients after the MWA at 1-, 2-, 3-, 4- and 5-year were 90.9%, 72.7%, 62.3%, 31.2% and 15.6%, respectively., Conclusion: The results showed that the neoplastic seeding was a low risk complication of percutaneous MWA of liver cancer and was considered acceptable in general., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To evaluate prospectively the correlation of scar-formations after vacuum-assisted biopsy with different systems and needle-sizes and interventional bleeding/post-interventional hematoma., Methods and Materials: Between 01/2008 and 12/2009, 479 patients underwent vacuum-assisted biopsy under stereotactic-guidance, using the Mammotome(®)-system with 11/8-gauge and ATEC(®)-system with 12/9-gauge, whereas in 178 cases with representative benign histology no surgical-biopsy after vacuum-assisted biopsy was performed and at least a 2-plane-follow-up-mammogram after 6 month post-vacuum-assisted biopsy was available. Bleeding during intervention, hematoma post-intervention and scar-tissue was scored as minimal and moderate/severe. Statistical analysis included Chi-Square-trend-test, p-value <0.05 was considered to be significant., Results: Significantly more bleedings and post-interventional hematomas for 8-gauge-Mammotome(®)-system vs. 11-gauge-Mammotome(®)-system (41.9% vs. 8.4%, p<0.001/35.5% vs. 16.7%, p=0.029), no significant-differences for the ATEC(®)-systems 9-gauge vs. 12-gauge (26.9% vs. 29.7%, p=0.799/42.3% vs. 43.2%, p=0.596). 11-gauge-Mammotome(®)-system vs. ATEC(®)-12-gauge-system revealed significantly less bleedings/hematomas (8.4% vs. 29.7%, p=0.015/16.7% vs. 43.2%, p=0.001), no significant differences for the large-systems (p=0.135/p=0.352). Follow-up of Mammotome(®)-11/8-gauge-system system has shown 13.1/16.1% minimal scar-formation and 1.2/3.2% moderate/severe scars, whereas ATEC(®)-12/9-gauge-system has shown 10.8/3.8% minimal scar-formation and 0/11.5% moderate/severe scars, no significant differences. No significant difference was found when comparing Mammotome(®)-11/8-g-systems vs. ATEC(®)-12/9-g-systems (p=0.609/p=0.823). There was also no correlation between risk of scar-formation after occurrence of bleeding or hematoma with any examined VAB-system or any needle size in this study (p=0.800)., Conclusion: Using larger needle-sizes significantly (Mammotome(®))/not significant for ATEC(®)) more interventional bleedings and post-interventional hematomas were detected, only a tendency concerning scar-formation., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Objective: To evaluate the use of the suture mediated vascular closure device concerning practicability and safety in clinical angiography practice., Material and Methods: One hundred and seventeen patients (59 female, 58 male, mean age 40.9+/-13.4) underwent percutaneous closure of common femoral arterial puncture sites following diagnostic neuroangiography using the suture device 'the Closer' (Perclose Inc., Redwood City, CA, USA). Primary success, early problems (within 24 h) and late complications were evaluated. Complications were graded as minor and severe with or without need of surgical intervention and categorized by type. Parameters such as age, gender, sheath size and number of previous arterial punctures were evaluated with respect to complications., Results: Percutaneous closure was primary successful in 85% (100/117). The overall complication rate was 32% (28% mild n=35, 4% severe n=6, which needed surgical intervention). All but one problem occurred within the first 24 h after the suture. Additional manual compression was necessary in 32 cases (25%). There was no significant difference in age and gender between the groups with and without complications. Sheath size was significantly larger (P<0.01) and numbers of preceeding angiograms were significantly higher (P<0.01) in the complications group compared with uncomplicated cases., Conclusion: The evaluated percutaneous vascular suture device is useful in clinical practice but limitations concerning patient selection seem to emerge in order to avoid complications.