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After sample collection, the biopsy tract was sealed by applying monopolar electrocauterization to the coaxial needle during its removal. Patient demographics, procedural details, contraindications (INR\u2009&gt;\u20091.5, platelet count\u2009&lt;\u200950,000\/mm\u00b3, ascites, antiplatelet\/anticoagulant use), pathology results, and complications were recorded. Follow-up imaging (range: 18\u2013360 days) was systematically reviewed to identify potential tumor seeding along the biopsy tract. All procedures were performed under ultrasound guidance with 4-h post-procedure observation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 102 biopsies yielded 100% diagnostic success rate with cirrhosis in 85.2% and HCC in 73.5% of patients. Most patients (75.8%) had at least one contraindication for standard biopsy. We observed one mortality in a high-risk Jehovah's Witness patient and one minor complication (hemoglobin drop) managed conservatively. Among 52 patients with follow-up imaging (mean 149 days), one case of suspected intrahepatic tract seeding occurred with no extrahepatic seeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This refined electrocauterization technique provides a safe, effective approach for obtaining diagnostic tissue in high-risk HCC patients with contraindications to standard percutaneous biopsy, offering advantages over conventional tract embolization methods through precise thermal effect localization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-026-05496-z","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T10:00:48Z","timestamp":1775210448000},"page":"5261-5268","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coaxial liver biopsy with tract electrocauterization: technique and outcomes in high-risk patients with suspected hepatocellular carcinoma"],"prefix":"10.1007","volume":"51","author":[{"given":"Tolga","family":"Zeydanli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammet Kursat","family":"Simsek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozgur","family":"Ozen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batuhan","family":"Kirisci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adem","family":"Safak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Boyvat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Haberal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"5496_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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