Subscribe to RSS
Download PDF
DOI: 10.4103/ijri.IJRI_347_18
Coronary artery air embolism complicating a CT-guided percutaneous lung biopsy
Subject Editor:
Financial support and sponsorship Nil.
Abstract
Coronary arterial air embolism is an extremely rare but readily recognizable condition on computed tomography (CT) that may complicate a lung biopsy. We present an incidence of symptomatic air embolism into the right coronary artery during a percutaneous CT-guided lung biopsy that was successfully recognized during the procedure and managed accordingly. An active search for this complication should be made when the patient deteriorates on table and the usual complications (pneumothorax, vasovagal shock, etc.) are ruled out, as immediate resuscitative measures could be life-saving.
Publication History
Article published online:
23 July 2021
© 2019. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Khan M, Schmidt DH, Bajwa T, Shalev Y. Coronary air embolism: incidence, severity, and suggested approaches to treatment. Cathet Cardiovasc Diagn 1995; 36: 313-8
- 2 Richardson CM, Pointon KS, Manhire AR, Macfarlane JT. Percutaneous lung biopsies: A survey of UK practice based on 5444 biopsies. Br J Radiol 2002; 75: 731-5
- 3 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; 59: 60-4
- 4 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. Am J Roentgenol 2009; 193: W430-6
- 5 Hare SS, Gupta A, Goncalves ATC, Souza CA, Matzinger F, Seely JM. Systemic arterial air embolism after percutaneous lung biopsy. Clin Radiol 2011; 66: 589-96
- 6 Goldfarb D, Bahnson HT. Early and late effects on the heart of small amounts of air in the coronary circulation. J Thorac Cardiovasc Surg 1963; 46: 368-78
- 7 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
- 8 Arnold BW, Zwiebel WJ. Percutaneous transthoracic needle biopsy complicated by air embolism. Am J Roentgenol 2002; 178: 1400-2
- 9 Muth CM, Shank ES. Gas embolism. N Engl J Med 2000; 342: 476-82
- 10 Glodny B, Schönherr E, Freund MC, Haslauer M, Petersen J, Loizides A. et al. Measures to prevent air embolism in transthoracic biopsy of the lung. Am J Roentgenol 2017; 208: W184-91
- 11 Sakiyama S, Kondo K, Matsuoka H, Yoshida M, Miyoshi T, Yoshida S. et al. Fatal air embolism during computed tomography-guided pulmonary marking with a hook-type marker. J Thorac Cardiovasc Surg 2003; 126: 1207-9
- 12 Jeannin A, Saignac P, Palussière J, Gékière JP, Descat E, Lakdja F. Massive systemic air embolism during percutaneous radiofrequency ablation of a primary lung tumor. Anesth Analg 2009; 109: 484-6
- 13 Balsara ZN, Burks DD. Hyperbaric oxygen therapy for arterial air embolism. AJR Am J Roentgenol 2007; 188: W98 author reply W99
- 14 Kawaji T, Shiomi H, Togashi Y, Gunji D, Imai M, Doi T. et al. Coronary air embolism and cardiogenic shock during computed tomography-guided needle biopsy of the lung. Circulation 2012; 126: 195-8