{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T02:06:10Z","timestamp":1770343570233,"version":"3.49.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A CT-guided tumor biopsies carry substantial risks, with literature-reported complication rates reaching 43% and pulmonary biopsy pneumothorax intervention rates as high as 22.1%. This study validates a novel needle tract sealing technique combining absorbable gelatin sponge (mechanical occlusion) with Agkistrodon acutus-derived hemocoagulase (local coagulation), leveraging synergistic physico-chemical mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective single-arm cohort enrolled 87 consecutive patients undergoing CT-guided biopsies (Feb 2023-Jun 2025). The core technique involved retrograde injection during needle withdrawal of 1mm\u00b3 gelatin sponge particles suspended in 0.5KU hemocoagulase (total volume: 1.5ml), with stratified dosing for D-dimer levels &amp;gt;2mg\/L. Primary outcomes were intervention-requiring complications such as symptomatic pneumothorax or clinically significant hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 87 patients (42 pulmonary), the composite technique reduced overall complications to 4.6% (4\/87) vs 43% literature rate (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Pulmonary biopsies achieved significantly lower pneumothorax intervention rates (2.38% vs 22.1%, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and subclinical stabilization of 87.9% imaging abnormalities. Organ-specific protection was observed in extrapulmonary biopsies (zero severe complications). D-dimer-stratified dosing reduced hyperfibrinolytic hemorrhage risk by 86.8% (<jats:italic>p<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The gelatin sponge-hemocoagulase composite significantly reduces CT-guided biopsy complications through dual mechanical-coagulation mechanisms, establishing a universally applicable, precision-stratified safety protocol.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1653386","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T04:11:51Z","timestamp":1758514311000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A gelatin sponge-hemocoagulase sealant for preventing tumor biopsy complications: a dual mechanical and pharmacological 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