Abstract
Computed tomography-guided percutaneous core needle biopsy of the lung is an undoubtedly useful and well-established interventional radiological procedure for the diagnosis of indeterminate pulmonary lesions. Complications of percutaneous core needle biopsy, such as pneumothorax and hemoptysis are considered mild and self-resolving, however systemic air embolism is considered a potentially fatal complication. Systemic air embolism occurs when the air enters a pulmonary vein secondary to a percutaneous CT-guided lung biopsy and is expelled into systemic circulation. Systemic air embolism is extremely rare: incidence of clinically apparent SAE is estimated at 0.061–0.17%, while clinically silent systemic air embolism may be as high as 3.8–4.8%. This study reports a case of air embolism in the cerebral arteries that resulted from a complex CT-guided percutaneous core needle biopsy of the lung. The present case highlights the main mechanisms of this pathology, risk factors, importance of complete thoracic CT after procedure, as well as management of rare complications.
Highlights
Computed tomography (CT) guided percutaneous lung biopsy is well-established diagnostic interventional radiological procedure for the diagnosis of undetermined pulmonary lesions
Computed tomography-guided percutaneous lung biopsy complicated by symptomatic systemic air embolism
Computed tomography-guided percutaneous lung biopsy complicated by symptomatic systemic air embolism post-procedural thoracic CT, among 1,010 CT-guided lung biopsies
Summary
Computed tomography (CT) guided percutaneous lung biopsy is well-established diagnostic interventional radiological procedure for the diagnosis of undetermined pulmonary lesions. Increasing number of CT-guided percutaneous core needle biopsies (PCNB) of the lung leads to rise of case reports of air embolism as a complication of this procedure. More severe complications include systemic air embolism (SAE), tumor see ding of the biopsy tract, severe pulmonary hemorrhage, hemothorax, and tension pneumothorax. In this case we present a clinical case of symptomatic SAE occurred in Vilnius University Hospital Santaros Clinics, Lithuania. Computed tomography-guided percutaneous lung biopsy complicated by symptomatic systemic air embolism. The day after the lung biopsy procedure patient felt well, without any neurological disfunction. 173
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