SinglePass Kronos electrocautery device for closure after percutaneous medical liver biopsy: Five case reports

Percutaneous liver biopsies, including coaxial needle biopsy (CNB), are the preferred method for tissue sampling to diagnose or characterize an array of hepatic conditions. Despite the advent of intraprocedural image guidance, and various "plugging" techniques, bleeding remains a frequent and potentially highly morbid complication, particularly in patients with bleeding risks. Thus, post-biopsy bleeding risk leads to extended patient monitoring, and in significant cases, additional imaging, intervention, and even surgery. Very rarely, death has resulted.

We report a series of five image-guided liver biopsy cases undertaken due to a variety of clinical conditions followed by the use of a new electrocautery hemostasis device called SinglePass Kronos. Indications for the CNB included non-alcoholic steatohepatitis, hepatocellular carcinoma and cirrhosis, abnormal liver function tests with positive autoimmune serologies, abnormal imaging findings, and jaundice. All biopsy procedures were successful with no complications through 30 days following CNB. Post-procedure ultrasound confirmed the absence of bleeding in all five cases.

Hemostasis of CNB tracts using SinglePass Kronos was obtained in all cases. Additional study of this device is warranted.