Erik K. Paulson, MD, G. Robert Stephenson, MD, Meg C

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Use of Fibrin Sealant as a Hemostatic Agent after Liver Biopsy in Swine Erik K. Paulson, MD, G. Robert Stephenson, MD, Meg C. Neal, RN, BSN, Victor Rossin, BS, Jeffrey H. Lawson, MD, PhD Journal of Vascular and Interventional Radiology Volume 11, Issue 7, Pages 905-911 (July 2000) DOI: 10.1016/S1051-0443(07)61810-7 Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 1 Fibrin sealant biopsy system. The fibrin sealant delivery kit (F), consisting of one 2-mL syringe of fibrinogen and one 2-mL syringe of thrombin, is attached to one arm of the 13-gauge sheath (arrow). A 14-gauge manual cutting needle (N) is placed into the other arm of the sheath through a one-way valve (arrowhead). After biopsy and removal of the cutting needle, the fibrin sealant is deployed into the biopsy tract by depressing the common plunger (small arrow), which ensures deployment of equal volumes of fibrinogen and thrombin. Journal of Vascular and Interventional Radiology 2000 11, 905-911DOI: (10.1016/S1051-0443(07)61810-7) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 2 Fibrin sealant delivery sheath. The sheath is a 14-cm, 13-gauge, metal-alloy blunt needle with a beveled tip. Attached to the hub of the sheath is a plastic “Y” adapter. One arm (arrow) of the “Y” adapter accepts the fibrin sealant kit. The other arm (arrowhead) of the adapter has a one-way valve that will accept a 14-gauge Tru-Cut needle. Journal of Vascular and Interventional Radiology 2000 11, 905-911DOI: (10.1016/S1051-0443(07)61810-7) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 3 (a) Active bleeding (arrow) from the liver after biopsy performed with the manual cutting needle without fibrin sealant. This animal was anticoagulated. (b) Liver biopsy site in an anticoagulated animal after biopsy performed with the fibrin sealant system. The solid fibrin plug (arrow) fills the tract and can be seen protruding from the biopsy site; there was no immediate or delayed bleeding. Journal of Vascular and Interventional Radiology 2000 11, 905-911DOI: (10.1016/S1051-0443(07)61810-7) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 4 (a) Photomicrograph of the biopsy tract created by a manual cutting needle without fibrin sealant. Note the blood filling the tract (arrows) (Hematoxylin-eosin, 103). (b) Photomicrograph of the biopsy tract after the deployment of fibrin sealant. Note that the fibrin sealant occupies the entire tract and insinuates along the edges. There is only a small amount of blood (arrows) along the tract (Hematoxylin-eosin, 43). Journal of Vascular and Interventional Radiology 2000 11, 905-911DOI: (10.1016/S1051-0443(07)61810-7) Copyright © 2000 Society of Interventional Radiology Terms and Conditions