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Published on: July 19, 2024
Systemic Air Embolism Complicating Computed Tomography-guided Percutaneous Transthoracic Biopsy of Cavitary Lung
James M Roberts1,2, Frank Y Chou1,2, Danielle Byrne1,2
1Department of Radiology, Vancouver General Hospital.
Purpose:
Cavitary lung lesions often pose a diagnostic challenge, and tissue sampling can be required to obtain a confident diagnosis. Many authors contend that a computed tomography-guided percutaneous transthoracic lung biopsy (PTLB) of a cavitary lung lesion places a patient at higher risk for systemic air embolism (SAE) compared with biopsy of a noncavitary lesion.
Materials And Methods:
We reviewed the literature for studies of SAE complicating PTLB. We searched English-language articles indexed through PubMed, Embase, and Ovid Medline and included articles published up to March 31, 2020.
Results:
We identified 10 case reports of SAE complicating PTLB, and 3 case-cohort studies comparing cavitary and noncavitary lesion biopsy. Among the case-cohort studies reviewed, 4 SAE occurred among 145 biopsies of cavitary lesions (2.7%), and 65 SAE occurred among 3050 biopsies of noncavitary lesions (2.1%). The pooled odds ratio of PTLB complicating SAE of cavitary lesions compared with noncavitary lesions was 1.29 (95% confidence interval: 0.47-3.60). No deaths following SAE after computed tomography-guided PTLB of cavitary lesions were reported in recent literature.
Conclusions:
On the basis of available evidence, air embolism rates are similar for PTLB of cavitary and noncavitary lesions. Additional research and registry studies are necessary to better understand this topic.
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