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Published on: May 23, 2015
Air embolism and needle track implantation complicating CT-guided percutaneous thoracic biopsy: single-institution
Kenji Ibukuro1, Rei Tanaka, Takaya Takeguchi
1Department of Radiology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan.
Insights
Air embolism and needle track implantation are complications of CT-guided thoracic biopsy. Their incidence is higher than previously reported, with air embolism occurring in 0.21% and needle track implantation in 0.56% of cases.
Area of Science:
- Radiology
- Thoracic Surgery
- Interventional Pulmonology
Background:
- Percutaneous CT-guided thoracic biopsy is a common procedure for diagnosing lung abnormalities.
- Potential complications include air embolism and needle track implantation, which require careful monitoring.
Purpose of the Study:
- To determine the incidence and characteristics of air embolism and needle track implantation following percutaneous CT-guided thoracic biopsy.
- To compare these complication rates with previously reported data.
Main Methods:
- Retrospective review of 1,400 percutaneous CT-guided thoracic biopsies performed between August 1993 and August 2008.
- Defined air embolism by hypotension and CT confirmation; defined needle track implantation by mass in the needle track on follow-up CT.
Main Results:
- Three cases (0.21%) of air embolism occurred, affecting major vessels and requiring resuscitation in two patients. One patient experienced transient hemiplegia.
- Four cases (0.56%) of needle track implantation were identified in malignant cases, presenting 4-7 months post-biopsy with masses ranging from 2.5-5.6 cm.
Conclusions:
- The incidence of clinically significant air embolism and needle track implantation after percutaneous thoracic biopsy is higher than previously documented.
- These findings highlight the importance of vigilance for these complications in patients undergoing thoracic biopsy.
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.
