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Preventing air embolism during percutaneous lung biopsy

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Project Overview

Course Number: BME 200/300



Project Name: Preventing air embolism during percutaneous lung biopsy



Short Name: air_embolism



Project description/problem statement: Interventional radiologists are asked to perform CT guided biopsies on smaller and smaller lung nodules; in addition, the IR physician is asked to send more tissue from smaller and smaller pulmonary nodules for genetic analysis to tailor therapy for the individual patient. Air embolism during percutaneous lung biopsy can be catastrophic and life ending for the patient.
A CT guided lung biopsy often requires a coaxial technique for performing the biopsy; additionally, a coaxial technique allows for multiple biopsies (i.e. samples to be obtained).

In a coaxial biopsy, either a seventeen gauge or 19 gauge guide needle is advanced under CT guidance to the proximal edge of the pulmonary nodule. Then the inner stylet is removed and the smaller diameter cutting needle is advanced and fired. For instance, a 19 gauge guide needle through which a 20 gauge biopsy gun is fired or similarly a 17 gauge guide needle through which an 18 gauge gun is fired.

importantly, the pressure within the lung is sub-atmospheric and during the removal of the stylet of the 19 or 17 gauge guide, air can rapidly enter the guide needle and result in air embolism if the biopsy is performed near an adjacent pulmonary vein. This will result in air embolism to the left atrium, left ventricle, aorta and God forbid the brain.

So to mitigate this risk, I would like to create a guide needle with a hemostasis valve on it; the inner stylet will fit snugly into the guide and allow ease of advancing to the superficial edge of the pulmonary nodule; when the guide needle is in satisfactory location, the inner stylet is removed and the sealing valve will reduce the chance of ambient atmospheric air rapidly entering into the lung. Thus multiple biopsies now may be done with much reduced risk of air embolism.



About the client: Dr. John C McDermott is a radiologist specialized in Abdominal CT Scan and Cholangiography

Team Picture

Team members from left to right: Nicholas Pauly, Timothy Madigan, Matthew Voigt, Abdel Daoud and Jacob Hawig
Team members from left to right: Nicholas Pauly, Timothy Madigan, Matthew Voigt, Abdel Daoud and Jacob Hawig

Contact Information

Team Members

  • Abdel Daoud - Team Leader
  • Timothy Madigan - Communicator
  • Matthew Voigt - BSAC
  • Jacob Hawig - BWIG
  • Nicholas Pauly - BPAG

Advisor and Client

  • Prof. Paul Campagnola - Advisor
  • Dr. John McDermott - Client

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