Skip to main content
SpringerLink
Log in

Cerebral air embolism treated with hyperbaric oxygen therapy following percutaneous transthoracic computed tomography-guided needle biopsy of the lung

  • Case Report
  • Published:
Radiation Medicine Aims and scope Submit manuscript

Abstract

A 71-year-old man presented with cough and sputum for 12 months. Chest radiography showed a homogeneous opacity in the right lower lobe. Computed tomography (CT) showed a nodular opacity, 2 cm in diameter, in the posterior segment of the right lower lobe. Mild emphysematous changes were also seen. With the patient in a prone position, a 19-gauge 7.8-cm introducer was placed in the lesion during a single inspiratory breath-hold. A coaxial 20-gauge automated needle was inserted through the introducer using a biopsy gun. Although the patient did not complain of any symptoms, postbiopsy CT showed air in the left ventricle and ascending aorta. After 5 h of bed rest, we found weakness in his left lower extremity. He was transferred to a hyperbaric oxygen chamber and recovered the next day. Air embolism is a rare, potentially fatal complication of percutaneous lung biopsy. Although the true effect of hyperbaric oxygen therapy is controversial, knowledge regarding the prompt management of such cases may help radiologists who perform this procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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;59:60–64.

    Article  PubMed  Google Scholar 

  2. Sinner WN. Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn (Stockh) 1976;17:813–828.

    CAS  Google Scholar 

  3. Peirce EC. Cerebral gas embolism with special reference to iatrogenic accidents. Hyperbaric Oxygen Rev 1:161–184.

  4. Wescott JL. Air embolism complicating percutaneus needle biopsy of the lung. Chest 1973;63:108–110.

    Article  Google Scholar 

  5. Aberle DR, Gamsu G, Golden JA. Fatal systemic air embolism following lung needle aspiration. Radiology 1987;165:351–353.

    PubMed  CAS  Google Scholar 

  6. Mokhlesi B, Ansaarie I, Bader M, Tareen M, Boatman J. Coronary artery air embolism complicating a CT-guided transthoracic needle biopsy of the lung. Chest 2002;121:993–996.

    Article  PubMed  Google Scholar 

  7. Emby DJ, Arnold BW, Zwiebel WJ. Percutaneous transthoracic needle biopsy complicated by air embolism. AJR Am J Roentgenol 2003;181:279–280.

    PubMed  CAS  Google Scholar 

  8. Muth CM, Shank ES. Gas embolism. N Engl J Med 2000;342:476–482.

    Article  PubMed  CAS  Google Scholar 

  9. Dutka AJ. A review of the pathophysiologic and potential application of experimental therapies for cerebral ischemia to the treatment of the cerebral arterial gas embolism. Undersea Biomed Res 1985;12:403–421.

    PubMed  CAS  Google Scholar 

  10. Arnold BW, Zwiebel WJ. Percutaneous transthoracic needle biopsy complicated by air embolism. AJR Am J Roentgenol 2002;178:1400–1402.

    PubMed  Google Scholar 

  11. Feldmeier JJ. Hyperbaric oxygen 2003: indications and results. In: The hyperbaric oxygen therapy committee report. Kensington, MD: Undersea and Hyperbaric Medical Society; 2003.

    Google Scholar 

  12. Lattin G Jr, O’Brien W Sr. Massive systemic air embolism treated with hyperbaric oxygen therapy following CT-guided transthoracic needle biopsy of a pulmonary nodule. J Vasc Interv Radiol 2006;17:1355–1358.

    Article  PubMed  Google Scholar 

  13. Ashizawa K, Watanabe H, Morooka H, Hayashi K. Hyperbaric oxygen therapy for air embolism complicating CT-guided needle biopsy of the lung. AJR Am J Roentgenol 2004;182:1606–1607.

    PubMed  Google Scholar 

  14. Worth ER, Burton JR, Landreneau RJ, Eggers GW Jr, Curtis JJ. Left arterial air embolism during intraoperative needle biopsy of a deep pulmonary lesion. Anesthesiology 1990;73:342–345.

    Article  PubMed  CAS  Google Scholar 

  15. 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. Chest 2007;132:684–690.

    Article  PubMed  Google Scholar 

  16. Khalil A, Pregent H, Parrot A, Carette M. Systemic air embolism complicating percutaneous transthoracic needle biopsy. AJR Am J Roentgenol 2006;187:W242–W243.

    Article  PubMed  Google Scholar 

  17. Mansour A, Abdel Raouf S, Qandeel M, Swaidan M. Acute coronary artery air embolism following CT-guided lung biopsy. Cardiovasc Intervent Radiol 2005;28:131–134.

    Article  PubMed  Google Scholar 

  18. Chakravarti R, Singh V, Isaac R, John MJ. Fatal paradoxical pulmonary air embolism complicating percutaneous computed tomography-guided needle biopsy of the lung. Aust Radiol 2004;48:204–206.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan

    Makiko Tomabechi, Kenichi Kato, Miyuki Sone & Shigeru Ehara

  2. Department of Medicine III, Iwate Medical University School of Medicine, Morioka, Japan

    Kenshi Sekimura & Tetsuya Kizawa

  3. Department of Neurology, Iwate Medical University School of Medicine, Morioka, Japan

    Masakado Kin

Authors
  1. Makiko Tomabechi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenichi Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miyuki Sone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigeru Ehara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenshi Sekimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tetsuya Kizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masakado Kin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Makiko Tomabechi.

About this article

Cite this article

Tomabechi, M., Kato, K., Sone, M. et al. Cerebral air embolism treated with hyperbaric oxygen therapy following percutaneous transthoracic computed tomography-guided needle biopsy of the lung. Radiat Med 26, 379–383 (2008). https://doi.org/10.1007/s11604-008-0242-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-008-0242-y

Key words

Search

Navigation