Top

BMC Medical Imaging

Published in:

Open Access 01-12-2018 | Case report

Systemic air embolism after percutaneous computed tomography-guided lung biopsy due to a kink in the coaxial biopsy system: a case report

Authors: Hsu-Chao Chang, Mei-Chen Yang

Published in: BMC Medical Imaging | Issue 1/2018

Abstract

Background

Systemic air embolism is a rare but potentially life-threatening complication of percutaneous computed tomography (CT)-guided lung biopsy. The incidence might be underestimated because of failure to diagnose this adverse event in asymptomatic patients; early recognition is difficult.

Case presentation

We report the case of a 73-year-old man with systemic air embolism, a complication of percutaneous CT-guided lung biopsy, due to a kink in the coaxial biopsy system. Serial post-procedure CT scans demonstrated the causal relationship.

Conclusions

Sequential post-biopsy CT scans demonstrated a causal relationship between this systemic air embolism and percutaneous biopsy, and allowed the radiologist to track the course of the emboli and their resolution. Awareness of air entry via the introducer needle and an early post-biopsy CT scan are crucial for early detection of systemic air embolism. If air embolism occurs in an asymptomatic patient, we recommend performing a delayed chest CT scan to follow the air’s course.

Tomiyama N, Yasuhara Y, Nakajima Y, Adachi S, Arai Y, Kusumoto M, et al. CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol. 2006;2006(59):60–4.CrossRef

Ibukuro K, Tanaka R, Takeguchi T, Fukuda H, Abe S, Tobe K. Air embolism and needle track implantation complicating CT-guided percutaneous thoracic biopsy: single-institution experience. AJR Am J Roentgenol. 2009;2009(193):W430–6.CrossRef

Ghafoori M, Varedi P. Systemic air embolism after percutaneous transthorasic needle biopsy of the lung. Emerg Radiol. 2008;15:353–6.CrossRefPubMed

Freund MC, Petersen J, Goder KC, Bunse T, Wiedermann F, Glodny B. Systemic air embolism during percutaneous core needle biopsy of the lung: frequency and risk factors. BMC Pulm Med. 2012;12:2.CrossRefPubMedPubMedCentral

Blanc P, Boussuges A, Henriette K, Sainty JM, Deleflie M. Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med. 2002;28:559–63.CrossRefPubMed

Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management. AJR Am J Roentgenol. 2011;196:W678–82.CrossRefPubMed

Bou-Assaly W, Pernicano P, Hoeffner E. Systemic air embolism after transthoracic lung biopsy: a case report and review of literature. World J Radiol. 2010;2:193–6.CrossRefPubMedPubMedCentral

Hiraki T, Fujiwara H, Sakurai J, Iguchi T, Gobara H, Tajiri N, et al. Nonfatal systemic air embolism complicating percutaneous CT-guided transthoracic needle biopsy: four cases from a single institution. Chest. 2007;132:684–90.CrossRefPubMed

Kau T, Rabitsch E, Celedin S, Habernig SM, Weber JR, Hausegger KA. When coughing can cause stroke--a case-based update on cerebral air embolism complicating biopsy of the lung. Cardiovasc Intervent Radiol. 2008;31:848–53.CrossRefPubMed

10.

Ho AM, Ling E. Systemic air embolism after lung trauma. Anesthesiology. 1999;90:564–75.CrossRefPubMed

11.

Arboix A, Alio J. Cardioembolic stroke: clinical features, specific cardiac disorders and prognosis. Curr Cardiol Rev. 2010;6:150–61.CrossRefPubMedPubMedCentral

12.

Muth CM, Shank ES. Gas embolism. N Engl J Med. 2000;342:476–82.CrossRefPubMed

13.

Valensi P, Lorgis L, Cottin Y. Prevalence, incidence, predictive factors and prognosis of silent myocardial infarction: a review of the literature. Arch Cardiovasc Dis. 2011;104:178–88.CrossRefPubMed

14.

Fujino M, Ishihara M, Ogawa H, Nakao K, Yasuda S, Noguchi T, et al. Impact of symptom presentation on in-hospital outcomes in patients with acute myocardial infarction. J Cardiol. 2017;70:29–34.CrossRefPubMed

15.

Zalewski A, Goldberg S, Dervan JP, Slysh S, Maroko PR. Myocardial protection during transient coronary artery occlusion in man: beneficial effects of regional beta-adrenergic blockade. Circulation. 1986;73:734–9.CrossRefPubMed

16.

McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011;124:40–7.CrossRefPubMedPubMedCentral

Title: Systemic air embolism after percutaneous computed tomography-guided lung biopsy due to a kink in the coaxial biopsy system: a case report
Authors: Hsu-Chao Chang
Mei-Chen Yang
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Medical Imaging / Issue 1/2018
Electronic ISSN: 1471-2342
DOI: https://doi.org/10.1186/s12880-018-0245-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Systemic air embolism after percutaneous computed tomography-guided lung biopsy due to a kink in the coaxial biopsy system: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Prognostic value of metabolic tumor volume of pretreatment 18F-FAMT PET/CT in non-small cell lung Cancer

Evaluation of the diagnostic performance of the simple method of computed tomography in the assessment of patients with shoulder instability: a prospective cohort study

Incidental finding of cardiac hydatid cysts, report of two cases

Standardized quality metric system for structural brain magnetic resonance images in multi-center neuroimaging study

Apparent diffusion coefficient as an effective index for the therapeutic efficiency of brain chemoradiotherapy for brain metastases from lung cancer

Malignancy rates of B3-lesions in breast magnetic resonance imaging – do all lesions have to be excised?