RT Journal Article SR Electronic T1 Systemic vascular air embolus following CT-guided transthoracic needle biopsy: a potentially fatal complication JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e240406 DO 10.1136/bcr-2020-240406 VO 14 IS 5 A1 Pia Iben Pietersen A1 Gitte Maria Jørgensen A1 Anders Christiansen YR 2021 UL http://casereports.bmj.com/content/14/5/e240406.abstract AB 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.