Preoperative computed tomography( CT)-guided marking with a short hook wire for small sized lung tumors has become popular along with the spread of thoracoscopic surgery. Systemic arterial air embolism is a very rare but potentially fatal complication. The patient was a 79-year-old man who was found to have a mixed ground glass opacity shadow on chest CT. Almost immediately after marking, he lost consciousness and complete atrio-ventricular (AV) block was found on the electrocardiogram (ECG) monitor. Brain CT showed intravascular air bubbles in the right frontal lobe. Two hours later, his conscious level was recovered completely but remained left hemiplegia. Five hours later, he was transported to another hospital for hyperbaric oxygen therapy. After 3 episodes of the treatment, left hemiplegia recovered with slight sense disorder in the left little finger. When neurologic findings are remained after air embolism, hyperbaric oxygen therapy should be arranged immediately.

Mizutani, Nakahara, Miyanaga, Yoshiya, , , , , (2012). [Hyperbaric oxygen therapy for air embolism complicating computed tomography (CT)-guided needle marking of the lung]. Kyobu geka. The Japanese journal of thoracic surgery, 2012 Sep;65(10):899-902. https://www.ncbi.nlm.nih.gov/pubmed/22940663