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Risk Factors for Systemic Air Embolism as a Complication of Percutaneous CT-guided Lung Biopsy: Multicenter Case-control Study

  • Clinical Investigation
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Abstract

Purpose

To determine risk factors for systemic air embolism by percutaneous computed tomography (CT)-guided lung biopsy.

Methods

This case-control study used data from 2216 percutaneous lung biopsy procedures performed over 11 years at 12 institutions in Japan. Systemic air embolism was identified by retrospective review of CT images obtained during and immediately after the procedures. To fulfill our objective, multiple variables were compared between cases and controls with univariate analyses by using Student’s t test and Fisher’s exact test for numerical and categorical values, respectively. Multivariate logistic regression analysis was then performed using selected variables.

Results

Ten cases of systemic air embolism and 2,206 controls were identified. Univariate analyses showed that the lesions in the lower lobe (P = 0.025) and occurrence of parenchymal hemorrhage (P = 0.019) were significant risk factors. Multivariate analysis showed that the use of a larger biopsy needle was a significant risk factor (P = 0.014).

Conclusion

Parenchymal hemorrhage during the procedure, lesions in the lower lobe, and the use of larger biopsy needles may be risk factors for systemic air embolism by percutaneous CT-guided lung biopsy. Our findings may provide clues toward minimizing the risk of this complication.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Hiroaki Ishii, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara & Susumu Kanazawa

  2. Department of Diagnostic Radiology 2, Kawasaki Hospital, Kawasaki Medical School, 2-1-80 Nakasange, Kita-ku, Okayama, 700-8505, Japan

    Hidefumi Mimura

  3. Department of Radiology, Okayama Saiseikai General Hospital, 1-17-18 Ifuku-cho, Kita-ku, Okayama, 700-8511, Japan

    Kotaro Yasui

  4. Department of Radiology, Fukuyama Medical Centre, 4-14-17 Okinogami-cho, Fukuyama, Hiroshima, 720-8520, Japan

    Tetsuya Doke

  5. Department of Radiology, Okayama Medical Centre, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan

    Takashi Mukai

  6. Department of Radiology, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama, 708-0841, Japan

    Hironori Kurokawa

  7. Department of Radiology, Chugoku Chuo Hospital, 148-13 Kamiiwanari, Miyuki-cho, Fukuyama, Hiroshima, 720-0001, Japan

    Yoshitomo Ando

  8. Department of Radiology, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji, Hyogo, 670-8540, Japan

    Soichiro Hase

  9. Department of Diagnostic and Interventional Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, Hiroshima, 721-8511, Japan

    Toshihiro Iguchi

  10. Department of Radiology, Okayama Red Cross Hospital, 2-1-1 Aoe, Kita-ku, Okayama, 700-8607, Japan

    Takayuki Yabuki

  11. Department of Radiology, Iwakuni Medical Centre, 2-5-1 Kuroiso-machi, Iwakuni, Yamaguchi, 740-8510, Japan

    Kenichi Omae

  12. Department of Radiology, Mitoyo General Hospital, 708 Himehama, Toyohama-cho, Kanonji, Kagawa, 769-1695, Japan

    Nobuhisa Tajiri

  13. Department of Epidemiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Toshiharu Mitsuhashi

Authors
  1. Hiroaki Ishii
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  2. Takao Hiraki
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  3. Hideo Gobara
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  4. Hiroyasu Fujiwara
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  5. Hidefumi Mimura
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  6. Kotaro Yasui
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  7. Tetsuya Doke
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  8. Takashi Mukai
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  9. Hironori Kurokawa
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  10. Yoshitomo Ando
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  11. Soichiro Hase
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  12. Toshihiro Iguchi
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  13. Takayuki Yabuki
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  14. Kenichi Omae
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  15. Nobuhisa Tajiri
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  16. Toshiharu Mitsuhashi
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  17. Susumu Kanazawa
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Corresponding author

Correspondence to Hiroaki Ishii.

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Ishii, H., Hiraki, T., Gobara, H. et al. Risk Factors for Systemic Air Embolism as a Complication of Percutaneous CT-guided Lung Biopsy: Multicenter Case-control Study. Cardiovasc Intervent Radiol 37, 1312–1320 (2014). https://doi.org/10.1007/s00270-013-0808-7

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  • DOI: https://doi.org/10.1007/s00270-013-0808-7

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