blood thinners

Wow, that's pretty challenging. You'll have to do some literature and online searching, I don't think picking our brains will give you the hard data you seek, although it may give you an idea of what is done in practice, in various areas.

You may want to contact a Medical Center that runs an Interventional Radiology Fellowship, or pick up an Interventional Radiology text (or two, or more, to compare).

Our practice for cardiac caths is: D/C Coumadin (warfarin) X 4days prior to cath, get an INR the morning of the cath.

Wait X 6 hr post Lovenox dose to perform cath.

Don't hold ASA (the benefit of the ASA out-weighs the risk of holding it, even on the morning of the cath).

Don't hold Plavix (same rationale as ASA, however if the pt needs bypass surgery, the surgeons are VERY reluctant to proceed if the pt has taken plavix that day).

Don't hold NSAIDS.

Now, the biopsies would require a different approach, depending on the organ or area to be biopsied. Liver, Lung, Renal Bx come to mind as those most needing careful pre-bx medication mgmt (or a transjugular approach for the Liver bx, if a coagulopathy exists).

I just did a quick Google search, and came up with mainly patient recommendations, which were, by and large, "inform your physician of any medications you take, including blood thinners or aspirin or herbal supplements, as you may need to discontinue these for several days before the biopsy."

We used to give out a post-biopsy patient information sheet that instructed pts to only take Tylenol for pain, not Ibuprofen, for 48 hr.

I'm sorry I haven't more solid, evidence-based information to give you, but do check into the Interventional Radiology textbooks. Good luck!