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Updated: Aug 6, 2026

Robotic-assisted Bronchoscopy Combined with Multimodal Imaging for Targeted Lung Cryobiopsies
Published on: July 19, 2024
Robotic-Assisted Navigational Bronchoscopy Complicated by Systemic Air Embolism
Paul K Jain1, Abdallatif Dawoud1, Mohammad Safi1
1The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA.
Background:
Robotic-assisted bronchoscopy (RAB) is a minimally invasive modality with a highly favorable safety profile. Systemic air embolism (SAE) is an exceedingly rare and catastrophic complication that is only recently emerging in literature surrounding RAB.
Case Summary:
A 74-year-old woman undergoing RAB developed an immediate ST-elevation myocardial infarction, airway bleeding, and cardiac arrest. Angiography revealed nonobstructive coronary arteries but identified a massive air embolism in the left ventricular apex. Her hospital course was complicated by severe cerebral edema, seizures, and acute limb ischemia.
Discussion:
We highlight a catastrophic instance of SAE resulting from RAB. We discuss its pathophysiology, imaging limitations, and the severe contraindications precluding hyperbaric oxygen therapy in patients with underlying structural lung disease.
Take-Home Messages:
SAE is a life-threatening RAB complication that can mimic acute coronary syndrome. Minimally invasive procedures carry fatal risks, especially in patients lacking the physiologic reserve to tolerate vital rescue treatments.
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