J Cerebrovasc Endovasc Neurosurg.  2016 Dec;18(4):391-395. 10.7461/jcen.2016.18.4.391.

Spontaneous Absorption of Cerebral Air Embolus Developed Accidentally during an Intra-arterial Procedure

• Yang TK

• KMID: 2367332
• DOI: http://doi.org/10.7461/jcen.2016.18.4.391

Abstract

Cerebral arterial air embolism (CAAE), although infrequent, is a complication that can occur at any time during an invasive medical procedure. We experienced two cases of CAAE during cerebral angiography accidentally. The author reports the two cases of CAAE wherein air emboli dissolved spontaneously and immediately under normal atmospheric pressure, not under therapeutic hyperbaric environment. One of the cases shows entire dissolution of the air embolus on the moving image. This report shows that arterial air embolus can be absorbed spontaneously, and air embolus size is one of the factors that influence air embolus dissolution besides hyperbaric oxygen condition.

Keyword

Air embolism; Cerebral angiography; Spontaneous dissolution

MeSH Terms

Absorption*
Atmospheric Pressure
Cerebral Angiography
Embolism*
Embolism, Air
Oxygen
Oxygen

Figure

• 

  Fig. 1 (A) The captured image of an air embolus (arrow) from the moving image at the distal end of the guiding catheter in the left internal carotid artery. (B) The captured image of an air embolus migrating distally along the ICA (arrow). The anteroposterior (C) and lateral (D) angiograms after the rotational moving image revealed no arterial occlusion in the whole ICA territory. ICA = internal carotid artery.

• 

  Fig. 2 The angiograms of the right ICA revealed a wandering air embolus (arrow) in the supraclinoid ICA (A, B) and hypoplastic right anterior cerebral artery (C). (D) Angiograms taken three minutes apart showed a decrease in size of the wandering embolus in the right ICA (arrow). The anteroposterior (E) and lateral (F) angiograms of the right ICA demonstrated no air embolus in the entire ICA territory. (G) The left vertebral artery angiogram revealed prominent flow in the posterior communicating artery (arrow). ICA = internal carotid artery.

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