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Systemic arterial air embolism following computed tomography (CT)-guided percutaneous lung biopsy: Case series and review of underlying risk factors, treatment and preventive strategies

Year: 2025

Type: article

Abstract: BACKGROUND: Systemic arterial air embolism is an uncommon but potentially fatal complication of CT-guided transthoracic lung biopsy. Although rare, it carries significant morbidity due to cerebral and coronary ischaemia. CASE PRESENTATION: We report two cases of systemic arterial air embolism occurring during CT-guided percutaneous lung biopsies. Both patients developed acute neurological deficits immediately following the procedure, attributed to cerebral air embolism. Imaging confirmed the presence of intracranial air in subarachnoid spaces. Neurological symptoms improved with supportive management, including oxygen administration and positioning. Histopathology in both cases revealed pulmonary adenocarcinoma. CONCLUSION: These cases highlight the importance of prompt recognition and appropriate management of systemic air embolism. Risk mitigation strategies include careful patient positioning, minimisation of intrapulmonary pressure gradients, and maintenance of needle occlusion. Although rare, this complication must be anticipated by interventionalists and managed promptly to avoid permanent neurological damage.

Source: Clinical Medicine

DOI: 10.1016/j.clinme.2025.100530

Authors: Maimuna Adamu, Chris Skillicorn, Timothy Stone, Harmesh Moudgil, Chulangani Abayaratne

Institutions: Shrewsbury and Telford Hospital NHS Trust, Keele University

Language: English

Topic: Lung Cancer Diagnosis and Treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500