Massive Systemic Air Embolism Treated with Hyperbaric Oxygen Therapy Following CT-guided Transthoracic Needle Biopsy of a Pulmonary Nodule

Lattin, Grant E.; O’Brien, William T.; McCrary, Brian F; Kearney, Patrick J.; Gover, David D.

doi:10.1097/01.rvi.0000231949.35479.89

Cited by 38 publications

(20 citation statements)

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“…The previously reported incidence of air embolism, with or without clinical symptoms, and needle track implantation was 0.01-0.4% [1-4] and 0.01-0.18% [3-6], respectively. Although there are more than 15 case reports [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] in the English-language literature, the authors of these reports did not usually present the incidence of these complications in each institution.Therefore we reviewed the cases of air embolism and needle track implantation in 1,400 percutaneous CT-guided thoracic biopsies that …”

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confidence: 99%

Air Embolism and Needle Track Implantation Complicating CT-Guided Percutaneous Thoracic Biopsy: Single-Institution Experience

Ibukuro

Tanaka

Takeguchi

et al. 2009

American Journal of Roentgenology

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confidence: 99%

Air Embolism and Needle Track Implantation Complicating CT-Guided Percutaneous Thoracic Biopsy: Single-Institution Experience

Ibukuro

Tanaka

Takeguchi

et al. 2009

American Journal of Roentgenology

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“…1,10 In addition, hyperbaric oxygen is considered to be the fi rst-line treatment of choice for arterial gas embolism. [11][12][13] With hyperbaric oxygen therapy, the patient breathes 100% oxygen at a Fig. 4.…”

Section: Discussionmentioning

confidence: 99%

Cerebral air embolism treated with hyperbaric oxygen therapy following percutaneous transthoracic computed tomography-guided needle biopsy of the lung

et al. 2008

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A 71-year-old man presented with cough and sputum for 12 months. Chest radiography showed a homogeneous opacity in the right lower lobe. Computed tomography (CT) showed a nodular opacity, 2 cm in diameter, in the posterior segment of the right lower lobe. Mild emphysematous changes were also seen. With the patient in a prone position, a 19-gauge 7.8-cm introducer was placed in the lesion during a single inspiratory breath-hold. A coaxial 20-gauge automated needle was inserted through the introducer using a biopsy gun. Although the patient did not complain of any symptoms, postbiopsy CT showed air in the left ventricle and ascending aorta. After 5 h of bed rest, we found weakness in his left lower extremity. He was transferred to a hyperbaric oxygen chamber and recovered the next day. Air embolism is a rare, potentially fatal complication of percutaneous lung biopsy. Although the true effect of hyperbaric oxygen therapy is controversial, knowledge regarding the prompt management of such cases may help radiologists who perform this procedure.

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“…The characteristics of symptomatic air embolism, based on the present and previously reported cases, are summarized in the following section (3,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In the majority of cases, the clinical symptoms of air embolism occur either during or immediately following needle biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Several precautionary measures have been proposed in order to minimize the risk of air embolism, such as avoiding biopsy through cystic or cavitary lesions or bullae, using a stylet to keep the needle closed airtight throughout the procedure, instructing the patient to suspend breathing during manipulation of the biopsy needle and minimizing the amount of aerated lung tissue penetrated while attempting to reach the lesion (12,22).…”

Section: Discussionmentioning

confidence: 99%

Systemic air embolism as a complication of CT-guided percutaneous core needle lung biopsy: A case report and review of the literature

Sun

Bian

Sheng-yuan

et al. 2015

Experimental and Therapeutic Medicine

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Abstract.Computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of the lung is a widely accepted and frequently performed interventional radiological procedure for the diagnosis of various pulmonary lesions. Common complications are usually mild and self-limited; however, air embolism is an extremely rare but potentially fatal complication. This study reports a case of fatal air embolism in the coronary and spinal arteries that resulted from a complex CT-guided PCNB of the lung. The present case suggests that multiple precautions may not eliminate the risk of the fatal air embolism resulting from the procedure of CT-guided PCNB. Prompt recognition and urgent resuscitation are crucial for initial stabilization, allowing subsequent diagnostic confirmation and appropriate treatment. The common characteristics of symptomatic air embolism, based on the case reported and a review of the literature, are summarized in the present study in order to provide recommendations for clinical practice.

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Massive Systemic Air Embolism Treated with Hyperbaric Oxygen Therapy Following CT-guided Transthoracic Needle Biopsy of a Pulmonary Nodule

Cited by 38 publications

References 10 publications

Air Embolism and Needle Track Implantation Complicating CT-Guided Percutaneous Thoracic Biopsy: Single-Institution Experience

Air Embolism and Needle Track Implantation Complicating CT-Guided Percutaneous Thoracic Biopsy: Single-Institution Experience

Cerebral air embolism treated with hyperbaric oxygen therapy following percutaneous transthoracic computed tomography-guided needle biopsy of the lung

Systemic air embolism as a complication of CT-guided percutaneous core needle lung biopsy: A case report and review of the literature

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