Utility of a Spring-loaded Blunt-tip Co-axial Needle in Accessing "Difficult-to-reach" Targets during Percutaneous Image-guided Procedures

<b>Purpose:</b> To review the utility of a spring-loaded blunt-tip co-axial needle in improving procedural outcomes when accessing "difficult-to-reach" targets during percutaneous image-guided procedures. <b>Material and Methods:</b> In this single-center retrospective study, consecutive adult patients who underwent percutaneous image-guided procedures using a spring-loaded blunt-tip co-axial needle for "difficult-to-reach" targets from January 2021 to December 2024 were reviewed. Clinical information, including demographics and medical history, was recorded. Pre- and post-procedural radiological findings were assessed. Procedural details, modality of image guidance, technical success, and complications were analyzed. Post-procedural follow-up was reviewed. <b>Results:</b> A total of 21 patients (median age: 68.0 years, range 33.0-88.0 years; 15 [71.4%] male) were included. Nearly half (n = 10, 47.6%) of the procedures were percutaneous image-guided drainage. One-third (n = 7, 33.3%) were hydrodissection performed for radiofrequency or microwave ablation of tumors. Three (14.3%) were image-guided biopsies. In one patient (4.8%), the needle was used for percutaneous embolization of a type II endoleak after endovascular repair of an enlarging internal iliac artery aneurysm. No procedure-related complication was encountered. In all 21 cases, adjacent organs were avoided, resulting in retained drainage, achieved tumor control with ablation, achieved tissue diagnosis with biopsy, and eliminated endoleak (100% technical success). <b>Conclusions:</b> The spring-loaded blunt-tip co-axial needle appeared to be useful in accessing "difficult-to-reach" targets in a variety of percutaneous image-guided procedures, including drainage, hydrodissection, biopsy, and percutaneous embolization of endoleak.