Air embolism and needle track implantation complicating CT-guided percutaneous thoracic biopsy: single-institution experience.
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.


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).


CONCLUSIONS
The incidence of air embolism with clinical symptoms and needle track implantation complicating percutaneous thoracic biopsy is more frequent than the previously reported rate.
Department of Radiology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan.
Kenji
K
Ibukuro
Rei
R
Tanaka
Takaya
T
Takeguchi
Hozumi
H
Fukuda
Shoko
S
Abe
Kimiko
K
Tobe
D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects*; D004618:Embolism, Air / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D013896:Thoracic Diseases / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed