Overcoming contraindications in liver biopsy: n-butyl cyanoacrylate tract embolization for high-risk cases

Objective: Liver biopsy is a well-established diagnostic method for assessing liver pathology. Percutaneous biopsy remains widely used but carries a risk of bleeding, particularly in patients with coagulopathy or other contraindications. This study evaluates the effectiveness of using N-butyl cyanoacrylate (NBCA) for tract embolization following percutaneous liver biopsy to reduce bleeding risk in high-risk patients. Methods: We retrospectively analyzed 50 patients who underwent ultrasound-guided liver biopsy with NBCA embolization between 2020 and 2024. Indications for biopsy included ascites, coagulopathy, anticoagulant use, and hypervascular masses. The primary outcomes assessed were diagnostic success and complication rates, particularly bleeding.Results: Patient ages ranged from 3 to 90 years, with a mean age of 53 (standard deviation: 24.28) years, and 54% were male. All procedures achieved sufficient tissue for diagnosis, with a 100% success rate, and no major complications or bleeding events were reported.Conclusion: Our findings support the safety and effectiveness of NBCA tract embolization as an adjunct to percutaneous liver biopsy, enabling safer diagnostic access for patients with contraindications. Further studies are encouraged to validate these findings and optimize protocol standardization.