Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis
Objectives To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis. Methods We searched the EMBASE and OVID-MEDLINE databases to identify studies that dea...
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| Veröffentlicht in: | European radiology 2021-04, Vol.31 (4), p.2022-2033 |
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| creator | Lee, Jong Hyuk Yoon, Soon Ho Hong, Hyunsook Rho, Ji Young Goo, Jin Mo |
| description | Objectives
To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis.
Methods
We searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed.
Results
The pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048–0.128%;
I
2
= 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029–34.279;
p
= 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103–91.469;
p
= 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725–14.925;
p
= 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149–9.492;
p
= 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309–20.447;
p
= 0.019).
Conclusion
The pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB.
Key Points
•
The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died.
•
The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism.
•
Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism. |
| doi_str_mv | 10.1007/s00330-020-07372-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7979673</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2503052277</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-d433f563556d76eb817e0240c5ddd1e84156b569c07869b726e8980c5090ec9a3</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEokvhBTggS1w4NHQc23HMAQlV_KlUqRc4W44z2bokdrCTrvZ9eFC8TSnQAwfLlr7ffDPjmaJ4SeEtBZCnCYAxKKHKRzJZlbtHxYZyVpUUGv642IBiTSmV4kfFs5SuAUBRLp8WRzlMUMlgU_w899Z16C2ekOjSd9IbO4eYTojxHZli2PqQZmeJ852z5iCR0JO0H6c5jOagGBcJjm0YXBqJ6WeMZMJol9l4DEsiczQ-zVchGpvpYfFb0rowpf07YrJRmnH1iXjjcLfmDWHALj_NsE8uPS-e9GZI-OLuPi6-ffr49exLeXH5-fzsw0VpBYe57DhjvaiZEHUna2wbKhEqDlZ0XUex4VTUraiVBdnUqpVVjY1qsgwK0CrDjov3q--0tCN2Fn2ufdBTdKOJex2M0_8q3l3pbbjRUklVS5YN3twZxPBjwTTr0SWLw7B-ha64oJQJXouMvn6AXocl5oYzJSDPp6qkzFS1UjaGlCL298VQ0Icl0OsS6LwE-nYJ9C4Hvfq7jfuQ31PPAFuBlCW_xfgn939sfwGPAMHg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2503052277</pqid></control><display><type>article</type><title>Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Lee, Jong Hyuk ; Yoon, Soon Ho ; Hong, Hyunsook ; Rho, Ji Young ; Goo, Jin Mo</creator><creatorcontrib>Lee, Jong Hyuk ; Yoon, Soon Ho ; Hong, Hyunsook ; Rho, Ji Young ; Goo, Jin Mo</creatorcontrib><description>Objectives
To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis.
Methods
We searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed.
Results
The pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048–0.128%;
I
2
= 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029–34.279;
p
= 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103–91.469;
p
= 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725–14.925;
p
= 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149–9.492;
p
= 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309–20.447;
p
= 0.019).
Conclusion
The pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB.
Key Points
•
The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died.
•
The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism.
•
Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-07372-w</identifier><identifier>PMID: 33051730</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arteries ; Biopsy ; Biopsy, Needle ; Chest ; Complications ; Confidence intervals ; Coronary artery ; Diagnostic Radiology ; Embolism ; Embolism, Air - epidemiology ; Embolism, Air - etiology ; Embolisms ; Heterogeneity ; Humans ; Imaging ; Incidence ; Indicators ; Internal Medicine ; Interventional Radiology ; Lung - diagnostic imaging ; Lungs ; Medicine ; Medicine & Public Health ; Neuroradiology ; Prognosis ; Radiology ; Regression analysis ; Risk analysis ; Risk Factors ; Statistical analysis ; Subgroups ; Systematic review ; Tomography, X-Ray Computed ; Ultrasound</subject><ispartof>European radiology, 2021-04, Vol.31 (4), p.2022-2033</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-d433f563556d76eb817e0240c5ddd1e84156b569c07869b726e8980c5090ec9a3</citedby><cites>FETCH-LOGICAL-c540t-d433f563556d76eb817e0240c5ddd1e84156b569c07869b726e8980c5090ec9a3</cites><orcidid>0000-0002-3700-0165</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-07372-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-07372-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33051730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Jong Hyuk</creatorcontrib><creatorcontrib>Yoon, Soon Ho</creatorcontrib><creatorcontrib>Hong, Hyunsook</creatorcontrib><creatorcontrib>Rho, Ji Young</creatorcontrib><creatorcontrib>Goo, Jin Mo</creatorcontrib><title>Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis.
Methods
We searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed.
Results
The pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048–0.128%;
I
2
= 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029–34.279;
p
= 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103–91.469;
p
= 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725–14.925;
p
= 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149–9.492;
p
= 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309–20.447;
p
= 0.019).
Conclusion
The pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB.
Key Points
•
The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died.
•
The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism.
•
Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism.</description><subject>Arteries</subject><subject>Biopsy</subject><subject>Biopsy, Needle</subject><subject>Chest</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Coronary artery</subject><subject>Diagnostic Radiology</subject><subject>Embolism</subject><subject>Embolism, Air - epidemiology</subject><subject>Embolism, Air - etiology</subject><subject>Embolisms</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Imaging</subject><subject>Incidence</subject><subject>Indicators</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lung - diagnostic imaging</subject><subject>Lungs</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Prognosis</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Subgroups</subject><subject>Systematic review</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9ks9u1DAQxiMEokvhBTggS1w4NHQc23HMAQlV_KlUqRc4W44z2bokdrCTrvZ9eFC8TSnQAwfLlr7ffDPjmaJ4SeEtBZCnCYAxKKHKRzJZlbtHxYZyVpUUGv642IBiTSmV4kfFs5SuAUBRLp8WRzlMUMlgU_w899Z16C2ekOjSd9IbO4eYTojxHZli2PqQZmeJ852z5iCR0JO0H6c5jOagGBcJjm0YXBqJ6WeMZMJol9l4DEsiczQ-zVchGpvpYfFb0rowpf07YrJRmnH1iXjjcLfmDWHALj_NsE8uPS-e9GZI-OLuPi6-ffr49exLeXH5-fzsw0VpBYe57DhjvaiZEHUna2wbKhEqDlZ0XUex4VTUraiVBdnUqpVVjY1qsgwK0CrDjov3q--0tCN2Fn2ufdBTdKOJex2M0_8q3l3pbbjRUklVS5YN3twZxPBjwTTr0SWLw7B-ha64oJQJXouMvn6AXocl5oYzJSDPp6qkzFS1UjaGlCL298VQ0Icl0OsS6LwE-nYJ9C4Hvfq7jfuQ31PPAFuBlCW_xfgn939sfwGPAMHg</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Lee, Jong Hyuk</creator><creator>Yoon, Soon Ho</creator><creator>Hong, Hyunsook</creator><creator>Rho, Ji Young</creator><creator>Goo, Jin Mo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3700-0165</orcidid></search><sort><creationdate>20210401</creationdate><title>Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis</title><author>Lee, Jong Hyuk ; Yoon, Soon Ho ; Hong, Hyunsook ; Rho, Ji Young ; Goo, Jin Mo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-d433f563556d76eb817e0240c5ddd1e84156b569c07869b726e8980c5090ec9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Arteries</topic><topic>Biopsy</topic><topic>Biopsy, Needle</topic><topic>Chest</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Coronary artery</topic><topic>Diagnostic Radiology</topic><topic>Embolism</topic><topic>Embolism, Air - epidemiology</topic><topic>Embolism, Air - etiology</topic><topic>Embolisms</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Imaging</topic><topic>Incidence</topic><topic>Indicators</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Lung - diagnostic imaging</topic><topic>Lungs</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Prognosis</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Subgroups</topic><topic>Systematic review</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Jong Hyuk</creatorcontrib><creatorcontrib>Yoon, Soon Ho</creatorcontrib><creatorcontrib>Hong, Hyunsook</creatorcontrib><creatorcontrib>Rho, Ji Young</creatorcontrib><creatorcontrib>Goo, Jin Mo</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Jong Hyuk</au><au>Yoon, Soon Ho</au><au>Hong, Hyunsook</au><au>Rho, Ji Young</au><au>Goo, Jin Mo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>31</volume><issue>4</issue><spage>2022</spage><epage>2033</epage><pages>2022-2033</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis.
Methods
We searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed.
Results
The pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048–0.128%;
I
2
= 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029–34.279;
p
= 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103–91.469;
p
= 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725–14.925;
p
= 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149–9.492;
p
= 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309–20.447;
p
= 0.019).
Conclusion
The pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB.
Key Points
•
The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died.
•
The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism.
•
Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33051730</pmid><doi>10.1007/s00330-020-07372-w</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-3700-0165</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2021-04, Vol.31 (4), p.2022-2033 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7979673 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Arteries Biopsy Biopsy, Needle Chest Complications Confidence intervals Coronary artery Diagnostic Radiology Embolism Embolism, Air - epidemiology Embolism, Air - etiology Embolisms Heterogeneity Humans Imaging Incidence Indicators Internal Medicine Interventional Radiology Lung - diagnostic imaging Lungs Medicine Medicine & Public Health Neuroradiology Prognosis Radiology Regression analysis Risk analysis Risk Factors Statistical analysis Subgroups Systematic review Tomography, X-Ray Computed Ultrasound |
| title | Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis |
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