FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1990626870> ?p ?o ?g. }

• W1990626870 endingPage "1209" @default.
• W1990626870 startingPage "1207" @default.
• W1990626870 abstract "Pulmonary marking with a hook wire, guided by computed tomography (CT), is often used to assist in the resection of small lung tumors that are difficult to identify by means of thoracoscopic surgical techniques or digital palpation. The most common complications accompanying this procedure are pneumothorax, intrapulmonary hemorrhage, and hemoptysis. These complications are usually mild, self-limiting, and curable. Air embolism is a widely recognized complication of transthoracic percutaneous needle biopsy, but in the case of CT-guided pulmonary marking, few complications have been reported. We report a case of fatal arterial gas embolism during hook wire localization of a pulmonary lesion. The patient mortality was mainly attributed to ischemic heart injury caused by air embolism. Physicians should be aware of this possible complication when a hook wire–type marker is used to avoid further fatalities. A 79-year-old woman visited our hospital for an examination of a 2.0-cm abnormal shadow in the left upper lung field revealed by a mass chest radiographic survey. A chest CT demonstrated a 1.5-cm tumor shadow with a faint density and ground-glass opacity in S8 of the right lung in addition to a 2.0-cm tumor in S1+2 of the left lung (Figure 1). The patient was known to have had pulmonary tuberculosis in her late twenties. She had no smoking history. Results of her physical examination were appropriate for her age. Complete blood count, liver function, renal function, and urinalysis showed no abnormality. Pulmonary function tests revealed a vital capacity (VC) of 2.04 L, a percent VC of 78.9%, a forced expiratory volume in 1 second (FEV1) of 1.04 L, and a ratio of FEV1 to forced vital capacity (FVC) of 65.8%. A CT-guided transthoracic needle biopsy was performed for the left-sided tumor, which was identified as a well-differentiated adenocarcinoma. The shadow of the right lung also indicated lung cancer. Simultaneous pulmonary wedge resections by video-assisted thoracoscopic surgery for both lesions were scheduled. On the day of the operation, CT-guided marking for the right pulmonary tumor was performed before the patient was sent to the operating room. The procedure was performed in the left-sided semilateral position with a hook-type marking needle (Guiding Marker System; Hakko Medical Co, Nagano, Japan). The patient was stable during the procedure. However, she had sudden cardiovascular collapse with unconsciousness, bradycardia, and hypotension as soon as she was returned to the supine position from the left-sided semilateral position after the procedure. Electrocardiography showed a remarkable ST-segment increase in leads II, III, aVF, and V1-3. One hundred percent oxygen was administered with a facemask. A hypertensor was administered, and spontaneous breathing was maintained. Chest CT scanning was performed promptly. The CT scan showed an air-fluid level in the ascending aorta and air density in the right coronary artery (Figure 2). After the air embolism was confirmed, the patient was transferred immediately to the intensive care unit (ICU). Although she temporarily regained consciousness after the accommodation in the ICU, she died of myocardial infarction caused by air embolism 22 hours after admission to the ICU. Although a small amount of hemoptysis was observed in the early period of the course, chest radiography showed no infiltration and pneumothorax. The hook wire was identified on the film. Pathologic autopsy was not performed. Gas embolism is a largely iatrogenic clinical problem that can result in serious morbidity and death.1Murphy B.P. Harford F.J. Cramer F.S. Cerebral air embolism resulting from invasive medical procedures. Treatment with hyperbaric oxygen.Ann Surg. 1985; 201: 242-245Crossref PubMed Scopus (121) Google Scholar Most reported cases of arterial gas embolism in relation to a lung procedure occur during percutaneous lung biopsy.2Wong R.S. Ketai L. Temes R.T. Follis F.M. Ashby R. Air embolus complicating transthoracic percutaneous needle biopsy.Ann Thorac Surg. 1995; 59: 1010-1011Abstract Full Text PDF PubMed Scopus (31) Google Scholar A reported case such as ours is rare. Recently, opportunities of locating small lesions in the lung and of performing video-assisted thoracoscopic surgery procedures have increased. Accordingly, some preoperative marking for small lesions are considered. Horan and colleagues3Horan T.A. Pinheiro P.M. Araujo L.M. Santiago F.F. Rodrigues M.R. Massive gas embolism during pulmonary nodule hook wire localization.Ann Thorac Surg. 2002; 73: 1647-1649Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar reported a case of arterial air embolism during hook wire localization for a pulmonary nodule. The structure of the hook wire used in that case was similar to the one used on our patient. Both hook apparatuses open into a V shape with spring force after releasing from an introducer (a covering needle). The possible mechanisms for air embolism during lung procedures are (1) communication between the bronchus, bronchiole, or air space and pulmonary vein and (2) communication between the pulmonary vein and the atmosphere. The first reason listed above is the most likely explanation for the outcome in our case. Although increase of airway pressure caused by a cough, the Valsalva maneuver, or positive pressure ventilation increases the risk,4Lalli A.F. McCormack L.J. Zelch M. Reich N.E. Belovich D. Aspiration biopsies of chest lesions.Radiology. 1978; 127: 35-40PubMed Google Scholar such circumstances were not found in our case. The second explanation seems less likely to apply to our case because it is doubtful that a large volume of air was sucked into the pulmonary vein through the needle. We measured the relationship between pressure gradient and airflow through the needle that we used. Under 6, 11, and 19 cm H2O of pressure gradient between the needle tip and its tail, 0, 0.14, and 0.39 mL/10 seconds of air passed through the needle, respectively. Horan and colleagues3Horan T.A. Pinheiro P.M. Araujo L.M. Santiago F.F. Rodrigues M.R. Massive gas embolism during pulmonary nodule hook wire localization.Ann Thorac Surg. 2002; 73: 1647-1649Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar described a probable mechanism of hook wire gas embolism. In that case the wire penetrated both the venule and the bronchiole, and as a result, the springing open hook wire introduced a connection between the two and caused an air embolism. In contrast to their case, in which the marking procedure was performed during positive pressure ventilation, our case was performed during spontaneous breathing. We could not find the cause of the increase in airway pressure. The lesion was located in the periphery of the right lower lobe and became the highest position in the chest under the left-sided semilateral position. Hence, the pulmonary vein blood pressure around where the hook wire was placed might become lower than the pressure of the airway. This situation might facilitate airflow into the pulmonary vein. The mortality and morbidity associated with transthoracic needle biopsy cannot be precisely determined but has been estimated at 0.02%5Greene R.E. Transthoracic needle aspiration biopsy.in: Athanasoulis C.A. Pfister R.C. Greene R.E. Robertson G.H. Interventional radiology. WB Saunders, Philadelphia1982: 587-634Google Scholar and 0.07%,6Tolly T.L. Feldmeier J.E. Czarnecki D. Air embolism complicating percutaneous lung biopsy.AJR Am J Roentgenol. 1988; 150: 555-556Crossref PubMed Scopus (55) Google Scholar respectively. Recently, the use of CT-guided pulmonary marking for small pulmonary lesions before video-assisted thoracoscopic surgery became more frequently used. Three cases of air embolism caused by CT-guided pulmonary marking were reported (Table 1). 3Horan T.A. Pinheiro P.M. Araujo L.M. Santiago F.F. Rodrigues M.R. Massive gas embolism during pulmonary nodule hook wire localization.Ann Thorac Surg. 2002; 73: 1647-1649Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar, 7Satake A. Kasugai T. Mizuno K. Saito Y. Urakami T. Japanese abstract.Jpn J Chest Surg. 2002; 16: 390Google Scholar, 8Kamiyoshihara M. Sakata K. Ishikawa S. Morishita Y. Cerebral arterial air embolism following CT-guided lung needle marking. Report of a case.J Cardiovasc Surg (Torino). 2001; 42: 699-700PubMed Google Scholar A hook-type marker was used in all cases. In 4 cases the lesions were present in the lower lobe of the lung. The positions in marking procedure of the 4 cases were the lateral or prone position.TABLE 1Air embolism complicating CT-guided pulmonary markingAuthor (y)Age (y), sexLocationTumor sizeMarkerPositionVentilation in the procedureDocumentation*Documentation: The sites where air was detected by CT.OutcomeOur case79, FS8 (right)15 mm21G, hook typeLeft semilateralSpontaneousChest CT (ascAo, CA)DeadSatake (2002)756, FS9 (right)15 mm21G, hook typeProneSpontaneousChest CT (LV, descAoAliveHoran (2002)332, MLower lobe (left)10 mm, 10 mm20G, hook typeRight lateralPositive airway pressureChest CT (descAo)AliveKamiyoshihara (2002)824, FS8 (right)4 mm22G, hook typeLeft lateralSpontaneous—†A chest CT indicated pneumothorax of the right lung.AliveAscAo, Ascending aorta; CA, coronary artery; LV, left ventricle; descAo, descending aorta.* Documentation: The sites where air was detected by CT.† A chest CT indicated pneumothorax of the right lung. Open table in a new tab AscAo, Ascending aorta; CA, coronary artery; LV, left ventricle; descAo, descending aorta. We have reported a case of fatal arterial gas embolism caused by marking with a hook wire for a pulmonary lesion. Because pulmonary marking will be used more frequently in the future, the risk of the hook wire should be reevaluated." @default.
• W1990626870 created "2016-06-24" @default.
• W1990626870 creator A5030815492 @default.
• W1990626870 creator A5033149750 @default.
• W1990626870 creator A5041031153 @default.
• W1990626870 creator A5057984405 @default.
• W1990626870 creator A5068328732 @default.
• W1990626870 creator A5075648700 @default.
• W1990626870 creator A5088408078 @default.
• W1990626870 date "2003-10-01" @default.
• W1990626870 modified "2023-10-16" @default.
• W1990626870 title "Fatal air embolism during computed tomography–guided pulmonary marking with a hook-type marker" @default.
• W1990626870 cites W1971918156 @default.
• W1990626870 cites W2026434116 @default.
• W1990626870 cites W2058323333 @default.
• W1990626870 cites W2061602728 @default.
• W1990626870 cites W2149974990 @default.
• W1990626870 doi "https://doi.org/10.1016/s0022-5223(03)00821-3" @default.
• W1990626870 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/14566279" @default.
• W1990626870 hasPublicationYear "2003" @default.
• W1990626870 type Work @default.
• W1990626870 sameAs 1990626870 @default.
• W1990626870 citedByCount "106" @default.
• W1990626870 countsByYear W19906268702012 @default.
• W1990626870 countsByYear W19906268702013 @default.
• W1990626870 countsByYear W19906268702014 @default.
• W1990626870 countsByYear W19906268702015 @default.
• W1990626870 countsByYear W19906268702016 @default.
• W1990626870 countsByYear W19906268702017 @default.
• W1990626870 countsByYear W19906268702018 @default.
• W1990626870 countsByYear W19906268702019 @default.
• W1990626870 countsByYear W19906268702020 @default.
• W1990626870 countsByYear W19906268702021 @default.
• W1990626870 countsByYear W19906268702022 @default.
• W1990626870 crossrefType "journal-article" @default.
• W1990626870 hasAuthorship W1990626870A5030815492 @default.
• W1990626870 hasAuthorship W1990626870A5033149750 @default.
• W1990626870 hasAuthorship W1990626870A5041031153 @default.
• W1990626870 hasAuthorship W1990626870A5057984405 @default.
• W1990626870 hasAuthorship W1990626870A5068328732 @default.
• W1990626870 hasAuthorship W1990626870A5075648700 @default.
• W1990626870 hasAuthorship W1990626870A5088408078 @default.
• W1990626870 hasBestOaLocation W19906268701 @default.
• W1990626870 hasConcept C126838900 @default.
• W1990626870 hasConcept C163716698 @default.
• W1990626870 hasConcept C164705383 @default.
• W1990626870 hasConcept C199343813 @default.
• W1990626870 hasConcept C2776265017 @default.
• W1990626870 hasConcept C2777185221 @default.
• W1990626870 hasConcept C2777586403 @default.
• W1990626870 hasConcept C2989005 @default.
• W1990626870 hasConcept C544519230 @default.
• W1990626870 hasConcept C71924100 @default.
• W1990626870 hasConceptScore W1990626870C126838900 @default.
• W1990626870 hasConceptScore W1990626870C163716698 @default.
• W1990626870 hasConceptScore W1990626870C164705383 @default.
• W1990626870 hasConceptScore W1990626870C199343813 @default.
• W1990626870 hasConceptScore W1990626870C2776265017 @default.
• W1990626870 hasConceptScore W1990626870C2777185221 @default.
• W1990626870 hasConceptScore W1990626870C2777586403 @default.
• W1990626870 hasConceptScore W1990626870C2989005 @default.
• W1990626870 hasConceptScore W1990626870C544519230 @default.
• W1990626870 hasConceptScore W1990626870C71924100 @default.
• W1990626870 hasIssue "4" @default.
• W1990626870 hasLocation W19906268701 @default.
• W1990626870 hasLocation W19906268702 @default.
• W1990626870 hasOpenAccess W1990626870 @default.
• W1990626870 hasPrimaryLocation W19906268701 @default.
• W1990626870 hasRelatedWork W2022867768 @default.
• W1990626870 hasRelatedWork W2044945895 @default.
• W1990626870 hasRelatedWork W2046859094 @default.
• W1990626870 hasRelatedWork W2051016982 @default.
• W1990626870 hasRelatedWork W2123911263 @default.
• W1990626870 hasRelatedWork W2137883693 @default.
• W1990626870 hasRelatedWork W2329051105 @default.
• W1990626870 hasRelatedWork W2351841284 @default.
• W1990626870 hasRelatedWork W2415828593 @default.
• W1990626870 hasRelatedWork W2421106607 @default.
• W1990626870 hasVolume "126" @default.
• W1990626870 isParatext "false" @default.
• W1990626870 isRetracted "false" @default.
• W1990626870 magId "1990626870" @default.
• W1990626870 workType "article" @default.