Abstract
Introducing gas to the circulation is a largely iatrogenic problem which can result in serious morbidity and even death. We report a case of CT-guided needle biopsy of a pulmonary lesion complicated by acute stroke. The English literature on cerebral air embolism is reviewed, including an update of current opinions on its pathomechanism, diagnostic findings, therapeutic strategies, and means of prevention.
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Aberle DR, Gamsu G, Golden JA (1987) Fatal systemic arterial air embolism following lung needle aspiration. Radiology 165:351–353
Murphy JM, Gleeson FV, Flower CD (2001) Percutaneous needle biopsy of the lung and its impact on patient management. World J Surg 25:373–379
Sinner WN (1976) Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn (Stockh) 17:813–828
Hiraki T, Fujiwara H, Sakurai J et al (2007) Nonfatal systemic air embolism complicating percutaneous CT-guided transthoracic needle biopsy: four cases from a single institution. Chest 132:684–690
Muth CM, Shank ES (2000) Gas embolism. N Engl J Med 342:476–482
Murphy BP, Harford FJ, Cramer FS (1985) Cerebral air embolism resulting from invasive medical procedures. Ann Surg 201:242–245
Mitchell S, Gorman D (2002) The pathophysiology of cerebral arterial gas embolism. J Extra Corpor Technol 34:18–23
Helps SC, Parsons DW, Reilly PL et al (1990) The effect of gas emboli on rabbit cerebral blood flow. Stroke 21:94–99
Schlimp CJ, Loimer T, Rieger M et al (2005) The potential of venous air embolism ascending retrograde to the brain. J Forens Sci 50:906–909
Westcott JL (1973) Air embolism complicating percutaneous needle biopsy of the lung. Chest 63:108–110
Mokhlesi B, Ansaarie I, Bader M et al (2002) Coronary artery air embolism complicating a CT-guided transthoracic needle biopsy of the lung. Chest 121:993–996
Ashizawa K, Watanabe H, Morooka H et al (2004) Hyperbaric oxygen therapy for air embolism complicating CT-guided needle biopsy ot the lung. AJR 182:1606–1607
Ashizawa K (2005) Possible airflow around the needle in lung biopsy. AJR 185:553
Evans DE, Kobrine AI, Weathersby PK et al (1981) Cardiovascular effects of cerebral air embolism. Stroke 12:338–344
Muir KW, Buchan A, von Kummer R et al (2006) Imaging of acute stroke. Lancet Neurol 5:755–768
Kodama F, Ogawa T, Hashimoto M et al (1999) Fatal air embolism as a complication of CT-guided needle biopsy of the lung. J Computer Assist Tomogr 23:949–951
Hirasawa S, Hirasawa H, Taketomi-Takahashi A et al (2008) Air embolism detected during computed tomography fluoroscopically guided transthoracic needle biopsy. CardioVasc Interv Radiol 31:219–221
Mansour A, AbdelRaouf S, Qandeel M et al (2005) Acute coronary artery air embolism following CT-guided lung biopsy. CardioVasc Interv Radiol 28:131–134
Fukaya E, Hopf HW (2007) HBO and gas embolism. Neurol Res 29:142–145
Mink RB, Dutka AJ (1995) Hyperbaric oxygen after global cerebral ischemia in rabbits reduces brain vascular permeability and blood flow. Stroke 26:2307–2312
Buras JA, Reenstra WR (2007) Endothelial-neutrophil interactions during ischemia and reperfusion injury: basic mechanisms of hyperbaric oxygen. Neurol Res 29:127–131
Smith RM, Van Hoesen KB, Neuman TS (1994) Arterial gas embolism and hemoconcentration. J Emerg Med 12:147–153
Arnold BW, Zwiebel WJ (2002) Percutaneous transthoracic needle biopsy complicated by air embolism. AJR 178:1400–1402
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Kau, T., Rabitsch, E., Celedin, S. et al. When Coughing Can Cause Stroke—A Case-Based Update on Cerebral Air Embolism Complicating Biopsy of the Lung. Cardiovasc Intervent Radiol 31, 848–853 (2008). https://doi.org/10.1007/s00270-008-9339-z
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DOI: https://doi.org/10.1007/s00270-008-9339-z