Symptomatic Air Embolism Research Articles

Symptomatic air embolism after computed tomography-guided four-hook needle localization of a pulmonary nodule: a case description.

Symptomatic air embolism after computed tomography-guided four-hook needle localization of a pulmonary nodule: a case description.

Air embolism after CT-guided localization of pulmonary ground-glass nodules.

To investigate the incidence of air embolism (AE) related to CT-guided localization of pulmonary ground-glass nodules (GGNs) prior to video-assisted thoracoscopic surgery (VATS). The data of all patients who received CT-guided localization of GGNs before VATS from May 2020 to October 2021 were retrospectively analyzed. A total of 1395 consecutive patients with 1553 GGNs were enrolled. AEs occurred in seven patients (0.5%). In four of the seven patients with AE, the embolism was detected before the patients left the CT table and emergency treatments were carried out. Among them, one patient had chest tightness and unilateral limb dyskinesia, one patient had convulsions and transient loss of consciousness, and two patients had no definite clinical symptoms. After a short-term high-flow oxygen inhalation, the clinical symptoms of two patients with symptomatic AE disappeared and two patients with asymptomatic AE did not show any symptoms. In the remaining three patients with AE, the embolism were detected retrospectively when evaluating the images in the PACS for this study. Fortunately, these three patients never developed clinical symptoms related to AE. All seven patients with AE underwent VATS on the day of localization and all GGNs were successfully removed under the guidance of markers. The incidence of AE related to CT-guided localization of GGNs was 0.5%, which was significantly higher than expected. Post-localization whole thoracic CT should be performed and observed carefully so as to avoid missed AE and delayed treatment. The incidence of AE related to CT-guided localization of GGNs was 0.5%. In order to timely detect AE, whole thoracic CT scan rather than local CT in the lesion area should be performed after localization. A small amount of AE may be missed if the post- localization CT images are not carefully observed.

Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis

ObjectivesTo determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis.MethodsWe searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed.ResultsThe pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048–0.128%; I2 = 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029–34.279; p = 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103–91.469; p = 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725–14.925; p = 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149–9.492; p = 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309–20.447; p = 0.019).ConclusionThe pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB.Key Points• The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died.• The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism.• Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism.

Systemic air embolism as a complication of CT-guided percutaneous core needle lung biopsy: A case report and review of the literature.

Computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of the lung is a widely accepted and frequently performed interventional radiological procedure for the diagnosis of various pulmonary lesions. Common complications are usually mild and self-limited; however, air embolism is an extremely rare but potentially fatal complication. This study reports a case of fatal air embolism in the coronary and spinal arteries that resulted from a complex CT-guided PCNB of the lung. The present case suggests that multiple precautions may not eliminate the risk of the fatal air embolism resulting from the procedure of CT-guided PCNB. Prompt recognition and urgent resuscitation are crucial for initial stabilization, allowing subsequent diagnostic confirmation and appropriate treatment. The common characteristics of symptomatic air embolism, based on the case reported and a review of the literature, are summarized in the present study in order to provide recommendations for clinical practice.

Massive Air Trapped in the Left Atrial Appendage During Catheter Ablation of Atrial Fibrillation Without a Symptomatic Air Embolism.

Journal of Cardiovascular ElectrophysiologyVolume 26, Issue 11 p. 1278-1278 EP Image Massive Air Trapped in the Left Atrial Appendage During Catheter Ablation of Atrial Fibrillation Without a Symptomatic Air Embolism AYAKO NAKAGAWA M.D., AYAKO NAKAGAWA M.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanSearch for more papers by this authorYUICHI HORI M.D., Corresponding Author YUICHI HORI M.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanAddress for correspondence: Yuichi Hori, M.D., 2-1-50 Minami Koshigaya, Koshigaya, Saitama 343-8555, Japan. Fax: +81-489-60-1708; E-mail: [email protected]Search for more papers by this authorSHIRO NAKAHARA M.D., Ph.D., SHIRO NAKAHARA M.D., Ph.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanSearch for more papers by this authorISAO TAGUCHI M.D., Ph.D., ISAO TAGUCHI M.D., Ph.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanSearch for more papers by this author AYAKO NAKAGAWA M.D., AYAKO NAKAGAWA M.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanSearch for more papers by this authorYUICHI HORI M.D., Corresponding Author YUICHI HORI M.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanAddress for correspondence: Yuichi Hori, M.D., 2-1-50 Minami Koshigaya, Koshigaya, Saitama 343-8555, Japan. Fax: +81-489-60-1708; E-mail: [email protected]Search for more papers by this authorSHIRO NAKAHARA M.D., Ph.D., SHIRO NAKAHARA M.D., Ph.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanSearch for more papers by this authorISAO TAGUCHI M.D., Ph.D., ISAO TAGUCHI M.D., Ph.D. Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanSearch for more papers by this author First published: 23 May 2015 https://doi.org/10.1111/jce.12717Citations: 1 Disclosures: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume26, Issue11November 2015Pages 1278-1278 RelatedInformation

Systemic Air Embolism

Systemic air embolism is a rare but potentially devastating complication of percutaneous chest biopsy that requires immediate diagnosis and rapid initiation of aggressive, noninvasive rescue therapy to prevent death or permanent neurologic sequelae. Radiologists focused on the most common complications of chest biopsy such as pneumothorax and parenchymal hemorrhage run the risk of failing to quickly diagnose and effectively treat systemic air embolism. Furthermore, the low incidence of symptomatic air embolism may lead to complacency and failure to prepare proper institutional procedures for the effective treatment. This case reviews the incidence, postulated mechanisms, and treatment of systemic air embolism caused by percutaneous chest biopsy.

VenaTrac™ Device for Over-the-Wire Placement of Chronic Dialysis Catheters

The VenaTrac™ is designed for exchange and primary placement of chronic tunneled hemodialysis catheters over a wire. It occludes both lumens of the catheter for the purpose of reducing the risk of air embolism and blood loss. The purpose of this paper is to report our experience with the use of this device. A retrospective review of chronic hemodialysis dialysis catheters exchanges over a 30-month period was performed. Two hundred and ninety-seven over-the-wire catheter exchanges and 47 primary placements using the VenaTrac™ device were reviewed. In addition, 430 over-the-wire catheter exchanges without the use of the VenaTrac™ were reviewed. No insertional complications or air embolism occurred when using the VenaTrac™. Symptomatic air embolism was documented in 5 out of 430 catheter exchanges performed without the use of VenaTrac™ (1.2%). VenaTrac™ over-the-wire insertion device demonstrated safe and reliable use with no incidence of air embolism.

Paradoxical Symptomatic Air Embolism after Saline Contrast Transesophageal Echocardiography

Paradoxical Symptomatic Air Embolism after Saline Contrast Transesophageal Echocardiography

Paradoxical Symptomatic Air Embolism after Saline Contrast Transesophageal Echocardiography

We describe one case of paradoxical air embolism after contrast transesophageal echocardiography realized to detect a patent foramen ovale. At the end of this procedure, the patient presented a left lateral homonymous hemianopsia attributed to air embolism. Total recovery was obtained after one therapeutic recompression.

Radiologic placement of implantable chest ports in pediatric patients.

We evaluated the technical success and complications associated with radiologic placement of implantable chest ports in children for long-term central venous access. Between May 1, 1996 and January 11, 2000, 29 chest ports were placed in 28 children (15 girls, 13 boys; age range, 2-17 years; mean, 11.7 years). The patient's right internal jugular vein was used for access in 93% (27/29) of the procedures, and a collateral neck vein was used as a conduit to recanalize the central veins in two procedures because of bilateral jugular and subclavian vein occlusion. All procedures were performed in interventional radiology suites. Both real-time sonography and fluoroscopy were used to guide venipuncture and port insertion. Follow-up data were obtained through the clinical examination and electronic review of charts. Technical success was 100%. Fourteen percent of the catheters were removed prematurely, including one catheter removed 17 days after placement because the patient's blood cultures were positive for Candida albicans. No patients experienced hematoma, symptomatic air embolism, symptomatic central venous thrombosis, catheter malposition, or pneumothorax. The median number of days for catheter use by patients was 280 days (total, 9043 days; range, 17-869 days). The rate of confirmed catheter-related infection was 14% or 0.04 per 100 venous access days. One catheter occluded after 132 days. In pediatric patients, radiologists can insert implantable chest ports using real-time sonographic and fluoroscopic guidance with high rates of technical success and low rates of complication.

Radiologic placement of subcutaneous infusion chest ports for long-term central venous access.

The technical success and complications associated with radiologic placement of subcutaneous implantable chest ports for long-term central venous access were evaluated. Between May 1, 1996, and December 31, 1996, 80 chest ports were placed in 80 consecutive patients using the right internal jugular vein as the preferred access route. All procedures occurred in interventional radiology suites with patients receiving conscious sedation. Both sonography and fluoroscopy were used for venipuncture and to guide port insertion. Follow-up was obtained by the clinical service and by performing chart reviews electronically. Technical success was 100%, and follow-up was obtained in all patients. One procedural complication occurred that was unrelated to actual catheter placement. Mean catheter use was 155 days (total, 12,168 days; range, 18-303 days). Confirmed catheter-related infection rate was 3%, or 0.016 per 100 access days; symptomatic catheter-related central venous thrombosis rate was 1%, or 0.008 per 100 access days; and 5% of catheters were removed prematurely. No instances of hematoma formation, catheter tip migration or malposition, symptomatic air embolism, spontaneous catheter fracture, or pneumothorax were found. With the benefit of both sonographic and fluoroscopic guidance, subcutaneous implantable chest ports can be inserted by radiologists with equal or lower complication rates than those reported in surgical series. Image-guided insertion of chest ports should replace rather than supplement unguided placement.

Effects of cardiac output on the clearance of air emboli from the superior vena cava.

The authors assessed the effect of cardiac output on the rate of clearance of air emboli from the superior vena cava (SVC) in 11 dogs placed in a supine 30 degrees head-up inclined position. Venous air emboli were produced by infusing 4 ml of air into the dorsal sagittal sinus. Air emboli appearance and clearance from the SVC were determined from the analog record produced by a transesophageal Doppler ultrasound monitor. Cardiac output was altered by changing the level of anesthesia and the administration of intravenous fluid. Eighty-eight per cent of air infusions resulted in an analog response of consistent amplitude indicating that all or a similar fraction of the infused air arrived consistently at the ensonified region of the SVC. In this group, air emboli passed from the SVC with a clearance time (CT) that was related inversely to the cardiac index (CI). CT = 24 CI-1.3 with a correlation coefficient = 0.57. Following 12% of the air infusions, there was evidence that a part of the air became detained in vascular sites cranial to the ensonified portion of the SVC. This evidence consisted of the following observations: analog responses were diminished in amplitude; subsequent air injections evoked responses that sometimes were exaggerated; and/or subsequent increases in cardiac output alone, produced spontaneous analog responses characteristic of air emboli. The authors postulate that air similarly may be detained in clinical settings and may explain such phenomenon as persistent precordial Doppler sounds of air emboli after pulmonary artery pressure has returned to normal following symptomatic air embolism and occurrence of air emboli after scalp closure.