Misono AS, Oftadeh B, Nguyen V, Dang Q, Young L, Patel T, Techasith T, Mesipam A, Baker C, Velling T. SinglePass Kronos electrocautery device for closure after percutaneous medical liver biopsy: Five case reports. World J Gastroenterol 2025; 31(40): 111158 [DOI: 10.3748/wjg.v31.i40.111158]
Corresponding Author of This Article
Alexander S Misono, MD, MBA, Department of Vascular and Interventional Radiology, Hoag Hospital, One Hoag Drive, Newport Beach, CA 92663, United States. amisono@newportradiology.com
Research Domain of This Article
Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 28, 2025 (publication date) through Oct 30, 2025
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Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Misono AS, Oftadeh B, Nguyen V, Dang Q, Young L, Patel T, Techasith T, Mesipam A, Baker C, Velling T. SinglePass Kronos electrocautery device for closure after percutaneous medical liver biopsy: Five case reports. World J Gastroenterol 2025; 31(40): 111158 [DOI: 10.3748/wjg.v31.i40.111158]
World J Gastroenterol. Oct 28, 2025; 31(40): 111158 Published online Oct 28, 2025. doi: 10.3748/wjg.v31.i40.111158
SinglePass Kronos electrocautery device for closure after percutaneous medical liver biopsy: Five case reports
Alexander S Misono, Behroz Oftadeh, Vincent Nguyen, Quan Dang, Lindsey Young, Trushar Patel, Tust Techasith, Avinash Mesipam, Christopher Baker, Thomas Velling
Alexander S Misono, Behroz Oftadeh, Vincent Nguyen, Quan Dang, Lindsey Young, Trushar Patel, Tust Techasith, Avinash Mesipam, Christopher Baker, Thomas Velling, Department of Vascular and Interventional Radiology, Hoag Hospital, Newport Beach, CA 92663, United States
Author contributions: Misono AS performed procedures and wrote the manuscript; Oftadeh B, Nguyen V, Dang Q, and Young L provided procedural support; Patel T, Techasith T, Mesipam A, and Baker C performed procedures; Velling T provided administrative support; all authors have read and approved the final manuscript.
Informed consent statement: Informed consent to perform the procedure was obtained from each patient. Study-specific informed consent is not required at our institution for case series of 5 or fewer patients.
Conflict-of-interest statement: Misono AS is a consultant and speaker for Single Pass, Inc. and an equity shareholder of Single Pass.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alexander S Misono, MD, MBA, Department of Vascular and Interventional Radiology, Hoag Hospital, One Hoag Drive, Newport Beach, CA 92663, United States. amisono@newportradiology.com
Received: June 26, 2025 Revised: August 29, 2025 Accepted: September 22, 2025 Published online: October 28, 2025 Processing time: 123 Days and 14 Hours
Abstract
BACKGROUND
Percutaneous liver biopsies, including coaxial needle biopsy (CNB), are the preferred method for tissue sampling to diagnose or characterize an array of hepatic conditions. Despite the advent of intraprocedural image guidance, and various “plugging” techniques, bleeding remains a frequent and potentially highly morbid complication, particularly in patients with bleeding risks. Thus, post-biopsy bleeding risk leads to extended patient monitoring, and in significant cases, additional imaging, intervention, and even surgery. Very rarely, death has resulted.
CASE SUMMARY
We report a series of five image-guided liver biopsy cases undertaken due to a variety of clinical conditions followed by the use of a new electrocautery hemostasis device called SinglePass Kronos. Indications for the CNB included non-alcoholic steatohepatitis, hepatocellular carcinoma and cirrhosis, abnormal liver function tests with positive autoimmune serologies, abnormal imaging findings, and jaundice. All biopsy procedures were successful with no complications through 30 days following CNB. Post-procedure ultrasound confirmed the absence of bleeding in all five cases.
CONCLUSION
Hemostasis of CNB tracts using SinglePass Kronos was obtained in all cases. Additional study of this device is warranted.
Core Tip: Percutaneous, image-guided medical liver biopsies are an invaluable tool in the diagnosis of a wide variety of hepatic diseases and conditions. Despite advances in tools and techniques, bleeding remains a frequent post-procedural complication, sometimes with significant sequelae. The SinglePass Kronos device was developed to provide hemostasis within the biopsy needle tract via electrocautery. This series of 5 case reports on Kronos use following percutaneous liver biopsy demonstrates Kronos integration into biopsy workflow with no post-procedural bleeding complications through 30 days. The Kronos device may be a valuable tool in preventing bleeding complications in percutaneous liver biopsies.
