Background/Objectives: Percutaneous kidney biopsy (PKB) is a valuable diagnostic tool for evaluating renal masses and suspected renal cancer but carries a risk of hemorrhagic complications. This study aimed to determine whether injecting a hemostatic Gelfoam mixture into the biopsy tract reduces post-procedural bleeding while maintaining diagnostic accuracy. Methods: This retrospective study included 500 patients who underwent PKB at our hospital between 2019 and 2024. Patients were equally divided into two groups: Group A (n = 250) received Gelfoam injection into the biopsy tract, and Group B (n = 250) underwent standard PKB without Gelfoam. Hemorrhagic complications were categorized as mild, mild–moderate, moderate, or severe based on immediate and 4-h post-procedure CT findings. Management protocols included same-day discharge for mild cases (with next-day re-evaluation) and 24-h observation for mild–moderate cases. Results: Group A had significantly fewer moderate–severe hemorrhages compared to Group B (1.3% vs. 4.0%, p = 0.034) and a higher rate of same-day discharge (84% vs. 40%, p < 0.05). These differences led to a notable reduction in total hospitalization days (43 vs. 167) and decreased overall costs. Diagnostic yield was similarly high in both groups (98.5% vs. 97.8%, p = 0.72). Conclusions: Gelfoam injection during PKB effectively reduces hemorrhagic complications and shortens hospital stay without compromising diagnostic accuracy. Routine use of Gelfoam—especially in high-risk patients—is supported by these findings, and further prospective studies are recommended to validate these results.

Background: Vascular malformations (VMs) are congenital anomalies of the vascular system—capillary, venous, lymphatic, arteriovenous, or combined—frequently associated with notable morbidity and reduced quality of life. Electrochemotherapy (ECT), a locoregional treatment that combines chemotherapeutic agents (most commonly bleomycin) with electroporation, has emerged as a promising alternative in managing therapy-resistant or anatomically challenging lesions. Methods: A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and the Cochrane Library were searched from inception to January 2025 for studies reporting on the efficacy and/or safety of ECT for vascular malformations. Data extraction encompassed study design, patient demographics, VM type, ECT protocols, outcomes, follow-up duration, and adverse events. Studies that lacked relevant outcome data or focused solely on other therapeutic approaches were excluded. Results: Twelve primary studies met the inclusion criteria and were analyzed. These covered diverse VMs, including venous, slow-flow, high-flow malformations, aggressive hemangiomas, and composite lesions in adult and pediatric populations. ECT protocols usually combined bleomycin (or occasionally other agents such as pingyangmycin or polidocanol foam) with various electroporation parameters. Across studies, ECT resulted in meaningful lesion-size reduction (50–97% in most cohorts), symptom relief (e.g., reduced pain and bleeding), and favorable cosmetic outcomes. While side effects (local edema, hyperpigmentation, procedure-related discomfort) were occasionally reported, they were typically mild and transient. Conclusions: ECT represents a valuable minimally invasive option in the therapeutic armamentarium for vascular malformations. Despite consistent demonstrations of efficacy and acceptable toxicity profiles, future high-quality, multicenter studies are warranted to confirm outcomes, refine treatment guidelines, and potentially expand its use as a standard of care.