SinglePass Kronos electrocautery device for closure of liver mass image-guided biopsy: a series of five case reports

Percutaneous liver mass biopsies, including coaxial needle biopsy (CNB), have become the preferred method for obtaining tissue samples in diagnosing or characterizing liver masses. Despite the advent of intraprocedural computed tomography (CT) and/or ultrasound image guidance as well as various biopsy tract "plugging" techniques, bleeding remains a frequent and potentially highly morbid complication. As such, patients often undergo extended monitoring. Furthermore, in cases of bleeding, patients may require additional imaging, intervention, and even surgery. Death, while very rare, is known to occur. We report a retrospective, observational, non-comparative series of five image-guided liver mass biopsy cases in which hemostasis and biopsy tract closure were obtained with a new electrocautery hemostasis device called the SinglePass Kronos electrocautery device. All biopsy procedures were technically successful, and there were no reported complications out to 30 days. Post-procedure imaging confirmed the absence of bleeding in all five cases. The SinglePass electrocautery device is a potentially valuable tool in minimizing bleeding complications in percutaneous solid organ biopsy procedures and has particular utility in high-risk biopsies such as liver mass biopsies. Larger-scale studies of this new device may be warranted.