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Systemic vascular air embolus following CT-guided transthoracic needle biopsy: a potentially fatal complication
  1. Pia Iben Pietersen1,2,
  2. Gitte Maria Jørgensen3 and
  3. Anders Christiansen1
  1. 1Department of Respiratory Medicine, Odense University, Odense, Denmark
  2. 2Simulation Center (SimC), Odense University Hospital, Odense, Denmark
  3. 3Department of Radiology, Odense University Hospital, Odense, Denmark
  1. Correspondence to Dr Pia Iben Pietersen; pia.iben.pietersen3{at}


Following an uncomplicated CT-guided transthoracic biopsy, a patient becomes unconscious and subsequently dies despite immediate cardiac resuscitation. The patient felt well during the procedure but started complaining about dizziness and chest pain when he sat up. When he again was put in a supine position, cardiac arrest was noted. A CT scan performed when the symptoms initiated was afterwards rigorously reviewed by the team and revealed air located in the left ventricle, aorta and right coronary artery.

We present a rare but potentially lethal complication following CT-guided transthoracic needle biopsy—systemic vascular air embolus. Knowledge and evidence about the complication are sparse because of low incidence and varying presentation. However, immediate initiation of treatment can save a life, and awareness of the complication is therefore crucial.

  • cancer intervention
  • radiology (diagnostics)
  • lung cancer (oncology)

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  • Contributors All three authors have made substantial contributions to the planning, conducting and reporting the work of the case report. All authors are guarantors and accept full responsibility for the work. The first and corresponding author, Dr PIP, has made the final revision and is in charge of submission with final approval from Ms GMJ and Mr AC.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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