Ring Shai, Pansuriya Tusharkumar, Rashid Hytham, Srinivasan Aswin, Kesavan Ramesh, Manjunath Skantha K, Jayaraman Gnananandh, Sarva Siva T
Department of Internal Medicine, HCA Houston Healthcare Kingwood, Houston, USA.
Department of Internal Medicine, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, USA.
Cureus. 2024 Feb 29;16(2):e55234. doi: 10.7759/cureus.55234. eCollection 2024 Feb.
To determine mortality and morbidity associated with coronary air embolism (CAE) secondary to complications of percutaneous lung biopsy (PLB) and illicit-specific risk factor associated with this complication and overall mortality, we searched PubMed to identify reported cases of CAE secondary to PLB. After assessing inclusion eligibility, a total of 31 cases from 26 publications were included in our study. Data were analyzed using Fisher's exact test. In 31 reported cases, cardiac arrest was more common after left lower lobe (LLL) biopsies (n=4, 80%, p=0.001). Of these patients who suffered from cardiac arrest, CAE was found more frequently in the right coronary artery (RCA) than other locations but did not reach statistical significance (n=5, 62%, p=0.39). At the same time, intervention in the LLL was significantly associated with patient mortality (n=3, 60%, p=0.010). Of the patients who died, CAE was more likely to have occurred in the RCA, but this association was not statistically significant (n=4, 57%, p=0.33). LLL biopsies have a statistically significant correlation with cardiac arrest and patient death. More research is needed to examine the effect of the air location in the RCA on patient morbidity and mortality.
为了确定经皮肺活检（PLB）并发症继发的冠状动脉空气栓塞（CAE）相关的死亡率和发病率，以及与该并发症相关的特定危险因素和总体死亡率，我们检索了PubMed以确定PLB继发CAE的报告病例。在评估纳入资格后，我们的研究纳入了来自26篇出版物的31例病例。使用Fisher精确检验分析数据。在31例报告病例中，左下叶（LLL）活检后心脏骤停更为常见（n = 4，80%，p = 0.001）。在这些发生心脏骤停的患者中，右冠状动脉（RCA）中发现CAE的频率高于其他部位，但未达到统计学意义（n = 5，62%，p = 0.39）。同时，LLL的干预与患者死亡率显著相关（n = 3，60%，p = 0.010）。在死亡患者中，CAE更有可能发生在RCA中，但这种关联无统计学意义（n = 4，57%，p = 0.33）。LLL活检与心脏骤停和患者死亡具有统计学显著相关性。需要更多研究来检查RCA中空气位置对患者发病率和死亡率的影响。
