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Systemic vascular air embolus following CT-guided transthoracic needle biopsy: a potentially fatal complication


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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