1
|
Ricciardella F, Mannetta G, Caruso V, Cocco G, Mantini C, Piccirilli E, Caulo M, Delli Pizzi A. Air embolism as a rare complication of lung biopsy: A case report. Radiol Case Rep 2024; 19:1547-1551. [PMID: 38317699 PMCID: PMC10839755 DOI: 10.1016/j.radcr.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
Lung biopsy is an important interventional radiology procedure allowing the characterization of lesions with suspected malignancy. The most frequent complications are pneumothorax and hemorrhage. Air embolism is a rare but potentially fatal occurrence. In this case report, we present an air embolism after core needle CT-guided biopsy showing CT and MRI features that radiologists should expect in the everyday clinical practice.
Collapse
Affiliation(s)
- Federica Ricciardella
- Department of Radiology, SS. Annunziata Hospital, “G. d'Annunzio” University, Chieti, Via dei Vestini, Chieti, Italy
| | - Gianluca Mannetta
- Department of Radiology, SS. Annunziata Hospital, “G. d'Annunzio” University, Chieti, Via dei Vestini, Chieti, Italy
| | - Valentina Caruso
- Department of Radiology, SS. Annunziata Hospital, “G. d'Annunzio” University, Chieti, Via dei Vestini, Chieti, Italy
| | - Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti, Italy
| | - Cesare Mantini
- Department of Radiology, SS. Annunziata Hospital, “G. d'Annunzio” University, Chieti, Via dei Vestini, Chieti, Italy
| | - Eleonora Piccirilli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti, Italy
| | - Massimo Caulo
- Department of Radiology, SS. Annunziata Hospital, “G. d'Annunzio” University, Chieti, Via dei Vestini, Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Radiology, SS. Annunziata Hospital, “G. d'Annunzio” University, Chieti, Via dei Vestini, Chieti, Italy
- Department of Innovative Technologies in Medicine & Odontoiatry, “G. d'Annunzio” University, Chieti, Italy
| |
Collapse
|
2
|
Ring S, Pansuriya T, Rashid H, Srinivasan A, Kesavan R, Manjunath SK, Jayaraman G, Sarva ST. Coronary Air Embolism Secondary to Percutaneous Lung Biopsy: A Systematic Review. Cureus 2024; 16:e55234. [PMID: 38558608 PMCID: PMC10981388 DOI: 10.7759/cureus.55234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
To determine mortality and morbidity associated with coronary air embolism (CAE) secondary to complications of percutaneous lung biopsy (PLB) and illicit-specific risk factor associated with this complication and overall mortality, we searched PubMed to identify reported cases of CAE secondary to PLB. After assessing inclusion eligibility, a total of 31 cases from 26 publications were included in our study. Data were analyzed using Fisher's exact test. In 31 reported cases, cardiac arrest was more common after left lower lobe (LLL) biopsies (n=4, 80%, p=0.001). Of these patients who suffered from cardiac arrest, CAE was found more frequently in the right coronary artery (RCA) than other locations but did not reach statistical significance (n=5, 62%, p=0.39). At the same time, intervention in the LLL was significantly associated with patient mortality (n=3, 60%, p=0.010). Of the patients who died, CAE was more likely to have occurred in the RCA, but this association was not statistically significant (n=4, 57%, p=0.33). LLL biopsies have a statistically significant correlation with cardiac arrest and patient death. More research is needed to examine the effect of the air location in the RCA on patient morbidity and mortality.
Collapse
Affiliation(s)
- Shai Ring
- Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Internal Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Tusharkumar Pansuriya
- Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Internal Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Hytham Rashid
- Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Internal Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Aswin Srinivasan
- Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Internal Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Ramesh Kesavan
- Department of Pulmonary and Critical Care Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Pulmonary and Critical Care Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Skantha K Manjunath
- Department of Pulmonary and Critical Care Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Pulmonary and Critical Care Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Gnananandh Jayaraman
- Department of Pulmonary and Critical Care Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Pulmonary and Critical Care Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| | - Siva T Sarva
- Department of Pulmonary and Critical Care Medicine, HCA Houston Healthcare Kingwood, Houston, USA
- Department of Pulmonary and Critical Care Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA
| |
Collapse
|
3
|
Zhang H, Wang S, Zhong F, Liao M. Risk factors for air embolism following computed tomography-guided percutaneous transthoracic needle biopsy: a systematic review and meta-analysis. Diagn Interv Radiol 2023; 29:478-491. [PMID: 36994842 PMCID: PMC10679610 DOI: 10.4274/dir.2022.221187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/07/2022] [Indexed: 01/15/2023]
Abstract
To quantitatively analyze the risk factors for air embolism following computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and qualitatively review their characteristics. The databases of PubMed, Embase, Web of Science, Wanfang Data, VIP information, and China National Knowledge Infrastructure were searched on January 4, 2021, for studies reporting the occurrence of air embolisms following CT-guided PTNB. After study selection, data extraction, and quality assessment, the characteristics of the included cases were qualitatively and quantitatively analyzed. A total of 154 cases of air embolism following CT-guided PTNB were reported. The reported incidence was 0.06% to 4.80%, and 35 (22.73%) patients were asymptomatic. An unconscious or unresponsive state was the most common symptom (29.87%). Air was most commonly found in the left ventricle (44.81%), and 104 (67.53%) patients recovered without sequelae. Air location (P < 0.001), emphysema (P = 0.061), and cough (P = 0.076) were associated with clinical symptoms. Air location (P = 0.015) and symptoms (P < 0.001) were significantly associated with prognosis. Lesion location [odds ratio (OR): 1.85, P = 0.017], lesion subtype (OR: 3.78, P = 0.01), pneumothorax (OR: 2.16, P = 0.003), hemorrhage (OR: 3.20, P < 0.001), and lesions located above the left atrium (OR: 4.35, P = 0.042) were significant risk factors for air embolism. Based on the current evidence, a subsolid lesion, being located in the lower lobe, the presence of pneumothorax or hemorrhage, and lesions located above the left atrium were significant risk factors for air embolism.
Collapse
Affiliation(s)
- Hanfei Zhang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shan Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Feiyang Zhong
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Meiyan Liao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|