The Incidence, Timing, and Presentation of Major Hemorrhagic Events Following Percutaneous Solid Organ Biopsies

Abstract

This retrospective study was performed to determine the incidence, timing, and clinical manifestations of major hemorrhagic events following percutaneous solid organ biopsy procedures in 32,331 cases performed between January 9, 2005, and September 8, 2023. Bleeding was categorized using the Common Terminology Criteria for Adverse Events (CTCAE). Major hemorrhage occurred in 139 cases (0.4%) and was most common after splenic biopsy (7/197, 3.6%) and native kidney parenchymal biopsy (41/4,108, 1.0%). Bleeding manifested within 1 hour in 60 cases (43%), between 1 and 2 hours in 15 cases (11%), between 2 and 24 hours in 46 cases (33%), and >24 hours in 18 cases (13%). Pain and hemodynamic instability were the most common manifestations, occurring in 96 (69%) and 63 (45%) patients, respectively. These findings confirm that the overall risk of major bleeding following solid organ biopsy is low, with splenic and renal biopsies entailing the highest risk. Delayed bleeding events are infrequent but should warrant consideration in guiding postprocedural follow-up.