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Bone Marrow Biopsy Procedure

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Ep 1 BM BX Devices: Jamshidi vs. OnControl with Dr. Aaron Fritts and Dr. Christopher Beck

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Pre-Procedure Prep

Bone Marrow Biopsy Indications

• Hematologic disorders such as leukemia, lymphoma, multiple myeloma, anemia, etc.

Contraindications

• Few if any
• Procedure can be performed in setting of thrombocytopenia
• Cellulitis at skin entry site or underlying soft tissue infection should prompt evaluation for different site

Pre-Procedural Evaluation

• H&P
• Prior imaging cross sectional imaging of the pelvis

Bone Marrow Biopsy Podcasts

Listen to leading physicians discuss bone marrow biopsy on the BackTable VI Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #1

BM BX Devices: Jamshidi vs. OnControl

Listen to New Orleans IR Christopher Beck MD and Dallas IR Aaron Fritts MD discuss preferences in bone biopsy needles.

Procedure Steps

Site

Most common site for bone marrow biopsy is iliac wing.

CT Guided Bone Marrow Biopsy

• Prone patient with posterior approach
• Advance needle along length of the iliac wing.
• For right iliac wing biopsy, operator stands on patient's left and skin entry site is midline with lateral trajectory
• Seat needle just beyond cortex. Occasionally, helpful to have mallet to assist with seating the needle beyond the cortex
• Remove inner stylet. Aspirate with large volume syringe (20 - 30 mL)
• Following aspiration, advance biopsy device without inner stylet into iliac wing 2-3 cm,
• Can be helpful to gently rock biopsy device to help capture specimen. Many devices have additional tools to assist with specimen capture

Following Successful Aspirate and Bone Biopsy

• Hemostasis with compression
• Apply sterile dressing
• Option to take final pictures confirming no immediate post operative complication

Post-Procedure

Bone Marrow Biopsy Complications

• Rare
• Bleeding is most common
• Injury to surround structures
• Patient's can be sore 2-3 days following procedure
• Inadequate sample

Bone Marrow Biopsy Recovery

• 15 minutes bedrest if local only
• Often times, moderate sedation will necessitate more recovery time than actual biopsy

Bone Marrow Biopsy Demos

Watch video walkthroughs of bone marrow biopsy on the BackTable VI expanded content network.

Arrow OnControl Bone Marrow Aspiration & Biopsy Procedure

Arrow OnControl Bone Marrow Biopsy Procedure Video

References

[1] Cohen MG, McMahon CJ, Kung JW, Wu JS. Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions. AJR Am J Roentgenol. 2016;206(5):W83‐W86. doi:10.2214/AJR.15.15067
[2] Lee RK, Ng AW, Griffith JF. CT-guided bone biopsy with a battery-powered drill system: preliminary results. AJR Am J Roentgenol. 2013;201(5):1093‐1095. doi:10.2214/AJR.12.10521
[3] BackTable, LLC (Producer). (2017, April 14). Ep 1 - BM BX Devices: Jamshidi vs OnControl [Audio podcast]. Retrieved from https://www.backtable.com/shows/vi

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