
REGULAR CONTENT
Final ID
648
Type
Educational Exhibit-Poster Only
Authors
S Behravesh1, C McCarthy2, S Naidu1, E Huettl3, M Knuttinen1, A Deipolyi4, R Oklu5
Institutions
1Mayo Clinic Arizona, Scottsdale, AZ, 2Massachusetts General Hospital, Boston, MA, 3Mayo Clinic Hospital, Phoenix, AZ, 4Memorial-Sloan Kettering Cancer Center, New York, NY, 5Mayo Clinic, Phoenix, AZ
Purpose
Air embolism is a rare but potentially fatal complication in a wide range of endovascular procedures including angiography and venous access. A high degree of awareness among interventional radiologists is essential for rapid recognition, as proactive management is critical for reducing morbidity and mortality. We sought to characterize 67 cases of air embolism cases to understand their causes, symptoms, clinical management, morbidity and mortality and outcomes.
Materials & Methods
This IRB approved retrospective study reviewed our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical and radiology records were data mined for all cases of air embolism over a 25-year period; patients with imaging evidence or high clinical suspicion of air embolism fulfilling the inclusion criteria and an antecedent event that could cause air embolism were identified. Variables including location of the event, immediate signs/symptoms, outcome at discharge and treatments utilized were noted and analyzed. Statistical analysis to assess for differences between groups of patients was performed using Fisher's exact test.
Results
67 air embolism cases were identified; mean age was 59 years (range 3-89). 94% occurred in hospital, of which 77.8% were during an operation/invasive procedure. Vascular access-related procedures (33%) were the most commonly associated with air embolism. Clinical signs and symptoms were related to the location of the air embolus; 36 cases to the right heart/pulmonary artery, 21 to the cerebrum, and 10 were attributed to patent foramen ovale. 21% of patients underwent hyperbaric oxygen therapy, 7.5% aspiration of the air and 63% had no sequelae. Mortality rate was 21%; 69% died within 48 hours. 13 patients had immediate cardiac arrest where mortality rate was 53.8%, compared to 13.5% (p=0.0035) in those without.
Conclusions
Air emboli are mainly iatrogenic, primarily associated with endovascular procedures. Mortality rate is high; high clinical suspicion and early treatment is critical for survival.
Final ID
648
Type
Educational Exhibit-Poster Only
Authors
S Behravesh1, C McCarthy2, S Naidu1, E Huettl3, M Knuttinen1, A Deipolyi4, R Oklu5
Institutions
1Mayo Clinic Arizona, Scottsdale, AZ, 2Massachusetts General Hospital, Boston, MA, 3Mayo Clinic Hospital, Phoenix, AZ, 4Memorial-Sloan Kettering Cancer Center, New York, NY, 5Mayo Clinic, Phoenix, AZ
Purpose
Air embolism is a rare but potentially fatal complication in a wide range of endovascular procedures including angiography and venous access. A high degree of awareness among interventional radiologists is essential for rapid recognition, as proactive management is critical for reducing morbidity and mortality. We sought to characterize 67 cases of air embolism cases to understand their causes, symptoms, clinical management, morbidity and mortality and outcomes.
Materials & Methods
This IRB approved retrospective study reviewed our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical and radiology records were data mined for all cases of air embolism over a 25-year period; patients with imaging evidence or high clinical suspicion of air embolism fulfilling the inclusion criteria and an antecedent event that could cause air embolism were identified. Variables including location of the event, immediate signs/symptoms, outcome at discharge and treatments utilized were noted and analyzed. Statistical analysis to assess for differences between groups of patients was performed using Fisher's exact test.
Results
67 air embolism cases were identified; mean age was 59 years (range 3-89). 94% occurred in hospital, of which 77.8% were during an operation/invasive procedure. Vascular access-related procedures (33%) were the most commonly associated with air embolism. Clinical signs and symptoms were related to the location of the air embolus; 36 cases to the right heart/pulmonary artery, 21 to the cerebrum, and 10 were attributed to patent foramen ovale. 21% of patients underwent hyperbaric oxygen therapy, 7.5% aspiration of the air and 63% had no sequelae. Mortality rate was 21%; 69% died within 48 hours. 13 patients had immediate cardiac arrest where mortality rate was 53.8%, compared to 13.5% (p=0.0035) in those without.
Conclusions
Air emboli are mainly iatrogenic, primarily associated with endovascular procedures. Mortality rate is high; high clinical suspicion and early treatment is critical for survival.