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Air Embolism and Needle Track Implantation Complicating CT-Guided Percutaneous Thoracic Biopsy: Single-Institution Experience

¹ All authors: Department of Radiology, Mitsui Memorial Hospital, 1-Kanda Izumicho, Chiyoda-ku, Tokyo 101-8643, Japan.

OBJECTIVE. The objective of our study was to present the details and incidence of air embolism and needle track implantation in patients who underwent percutaneous CT-guided thoracic biopsy.

MATERIALS AND METHODS. We retrospectively reviewed 1,400 percutaneous CT-guided thoracic biopsies during the period from August 1993 to August 2008. A case with air embolism was considered to be a patient with hypotension during or after biopsy and with an air embolism confirmed on CT. A needle track implantation was considered to be a mass in the needle track on the postbiopsy follow-up CT.

RESULTS. There were three (0.21%) cases of air embolism. Air embolisms were confirmed in the left ventricle, coronary artery, ascending aorta, and pulmonary vein. The pulmonary venous wall was pathologically identified in one case. Although there were no fatalities, two patients needed resuscitation. Left hemiplegia occurred in one case, but it gradually disappeared. There were four (0.56%) cases of needle track implantation in 713 pathologically proven malignant thoracic biopsy cases with follow-up CT scans. Two were primary lung cancer and the others were lung metastasis (renal cell carcinoma and osteosarcoma). Implantation was found 4–7 months (mean, 5.6 months) after the biopsy, and size was 2.5–5.6 cm (mean, 3.5 cm).

CONCLUSION. The incidence of air embolism with clinical symptoms and needle track implantation complicating percutaneous thoracic biopsy is more frequent than the previously reported rate.

Keywords: air embolism • CT • lung biopsy • needle track implantation • pulmonary vein

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