Complications following US-guided core-needle biopsy for thyroid lesions: a retrospective study of 6,169 consecutive patients with 6,687 thyroid nodules

Abstract

OBJECTIVES: To present the various complications of ultrasound (US)-guided core needle biopsy (CNB) of thyroid lesions in a large patient series. METHODS: From January 2008 to March 2013, 6,169 patients underwent US-guided CNB of 6,687 thyroid nodules at a single institution. We assessed the number and types of major and minor complications, and evaluated the factors associated with complications. RESULTS: Overall, 53 complications were observed in 50 patients (0.81 %), including 4 major and 49 minor complications. The major complications were massive haematoma (n = 2), pseudoaneurysm (n = 1) and voice change leading to disability that lasted for more than 30 days (n = 1). The minor complications were small to moderate haematoma (n = 42), carotid injury (n = 2), voice change that recovered within 30 days (n = 3), tracheal puncture (n = 1) and dysphagia (n = 1). Oedema (n = 12), vertebral puncture (n = 3) and vasovagal reaction (n = 1) were recorded as side effects. The presence of a coprocedure was the only significant factor associated with complications after thyroid CNB (P = 0.023). CONCLUSIONS: US-guided CNB of thyroid lesions was found in a large population to be a safe procedure with a low complication rate. KEY POINTS: * The complication rate after US-guided CNB for thyroid lesions was 0.81 % (50/6,169). * The rate of major complications was 0.06 % (4/6,169). * Vascular injury was the most common complication (47/6,169: 0.76 %). * None of the patients experienced permanent problems resulting from complications.