Underestimated pulmonary hemorrhage—a fatal complication combined with systemic air embolism after CT-guided lung biopsy: a case description

Fang, Xingyu; Li, Jialin; Sun, Bin; Liu, Mingxia; Tang, Zhiquan

doi:10.21037/qims-20-1290

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…A common complication is pulmonary hemorrhage, with a reported incidence of 31.38% (342/1,090), and includes lower-grade (24.4%, 266/1,090) and higher-grade hemorrhage (6.97%, 76/1,090) ( 12 ). The most fatal complication is air embolism ( 13 ). However, CT-guided hookwire placement also has its drawbacks, such as pneumothorax, hemothorax, subcutaneous emphysema, and wire shedding ( 14 , 15 ), in addition to life-threatening complications caused by air embolism, such as cerebral infarction, epilepsy, temporary and permanent paralysis, shock, and cardiac arrest ( 14 , 16 ).…”

Section: Ct-guided Percutaneous Placement Of Markersmentioning

confidence: 99%

Intraoperative identification of pulmonary nodules during minimally invasive thoracic surgery: a narrative review

Lü¹,

Zhang²,

Wang³

2022

Quant Imaging Med Surg

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Background and Objective: The increasingly widespread application of computed tomography (CT) in the screening and follow-up of patients with lung disease has concomitantly increased the detection rate of pulmonary nodules. Currently, minimally invasive thoracic surgery (MITS) has become the preferred method of surgery for patients with pulmonary ground-glass nodules (GGNs) due to its advantages minimal invasiveness and rapid recovery. However, target nodule identification during MITS is sometimes challenging due to the inherent characteristics of these nodules, especially when they are small and distant from the pleura. This review details the many methods used for the intraoperative localization of pulmonary nodules. Methods: Literature published in the Cochrane Library, PubMed, ClinicalTrials, and China National Knowledge Infrastructure from 1990 to 2022 were searched and analyzed to obtain a comprehensive review of the different methods of identifying pulmonary nodules. Literature related to animal testing were excluded. Key Contents and Findings: An overview of the recent progress in the clinical methods for intraoperative localization of pulmonary nodules [including CT-guided percutaneous placement of markers; bronchoscopy-guided placement of markers; intraoperative ultrasonography; three-dimensional (3D) printing technology; artificial intelligence (AI); and intraoperative molecular imaging (IMI)] was conducted. The advantages and disadvantages, as well as the complications associated with existing research methods, were summarized to assist doctors in the development of optimized clinical strategies. Conclusions: Clinicians can communicate with the multidisciplinary team and select the appropriate positioning method according to each patient's individual situation and the available support of the equipment and technology of the institution. Certain non-invasive and specific identification methods may have clinical potential in pulmonary nodule localization in the future.

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Section: Ct-guided Percutaneous Placement Of Markersmentioning

confidence: 99%

Intraoperative identification of pulmonary nodules during minimally invasive thoracic surgery: a narrative review

Lü¹,

Zhang²,

Wang³

2022

Quant Imaging Med Surg

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“…Hence, there is a mounting demand for CT-guided coaxial core needle biopsy (CCNB), which plays an important role in the pathological and cytological evaluation of pulmonary parenchymal lesions (3,4). Although CCNB has been recognized as a relatively safe and less invasive medical diagnostic workup, it is inevitably accompanied by the risk of procedure-related complications (5,6). Pneumothorax is the most common complication of CT-guided CCNB, with a rate of 2.4-60% (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a prediction model of pneumothorax after CT-guided coaxial core needle lung biopsy

Zhao¹,

Bao²,

Wu³

et al. 2022

Quant Imaging Med Surg

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Background: Pneumothorax is the most common complication of computed tomography-guided coaxial core needle biopsy (CCNB) and may be life-threatening. We aimed to evaluate the risk factors and develop a model for predicting pneumothorax in patients undergoing computed tomography-guided CCNB, and to further determine its clinical utility. Methods: Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for pneumothorax from 18 variables. A predictive model was established using multivariable logistic regression and presented as a nomogram based on a training cohort of 690 patients who underwent computed tomography-guided CCNB. The model was validated in 253 consecutive patients in the validation cohort and 250 patients in the test cohort. The area under the curve was used to determine the predictive accuracy of the proposed model. Results: The risk factors associated with pneumothorax after computed tomography-guided CCNB were sex, patient position, lung field, lesion contact with the pleura, lesion size, distance from the pleura to the lesion, presence of emphysema adjacent to the biopsy tract, and crossing fissures. The predictive model that incorporated these predictors showed good predictive performance in the training cohort [area under the curve, 0.71 (95% confidence interval: 0.67-0.75)], validation cohort [0.71 (0.64-0.78)], and internal test cohort [0.68 (0.60-0.75)]. The nomogram also provided excellent calibration and discrimination, and decision curve analysis (DCA) demonstrated its clinical utility.Conclusions: The predictive model showed good performance for pneumothorax after computed tomography-guided CCNB and may help improve individualized preoperative prediction.

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Underestimated pulmonary hemorrhage—a fatal complication combined with systemic air embolism after CT-guided lung biopsy: a case description

Cited by 2 publications

References 14 publications

Intraoperative identification of pulmonary nodules during minimally invasive thoracic surgery: a narrative review

Intraoperative identification of pulmonary nodules during minimally invasive thoracic surgery: a narrative review

Development and validation of a prediction model of pneumothorax after CT-guided coaxial core needle lung biopsy

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