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Coronary Air Embolism Secondary to Percutaneous Lung Biopsy: A Systematic Review

Shai Ring1,2, Tusharkumar Pansuriya1,2, Hytham Rashid1,2

  • 1Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, USA.

Cureus
|April 1, 2024
PubMed

Insights

Percutaneous lung biopsies (PLB) in the left lower lobe (LLL) are linked to cardiac arrest and patient death due to coronary air embolism (CAE). Further research is needed on CAE location and patient outcomes.

Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Interventional Radiology

Background:

  • Coronary air embolism (CAE) is a rare but serious complication.
  • Percutaneous lung biopsy (PLB) is an essential diagnostic tool.
  • Understanding risks associated with PLB is crucial for patient safety.

Purpose of the Study:

  • To determine mortality and morbidity associated with CAE following PLB.
  • To identify risk factors for CAE and overall mortality after PLB.
  • To analyze the impact of biopsy location on CAE complications.

Main Methods:

  • Systematic literature search of PubMed for reported cases of CAE secondary to PLB.
  • Inclusion of 31 cases from 26 publications.
  • Statistical analysis using Fisher's exact test.

Main Results:

  • Left lower lobe (LLL) biopsies were significantly associated with cardiac arrest (p=0.001).
  • LLL biopsies were also significantly correlated with patient mortality (p=0.010).
  • CAE occurred more frequently in the right coronary artery (RCA) in patients with cardiac arrest and mortality, but without statistical significance.

Conclusions:

  • Biopsies of the LLL are significantly associated with increased risk of cardiac arrest and mortality.
  • The location of CAE within the RCA may influence outcomes, warranting further investigation.
  • More research is needed to fully understand the relationship between CAE location and patient morbidity/mortality.

Keywords:
acute coronary syndromebiopsy methodbiopsy needlecoronary air embolismhyperbaric oxygen thetapyin hospital cardiac arrestleft lower lobepercutaneous lung biopsyright coronary arterysystemic air emboli

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