Life-threatening hemorrhage due to percutaneous transthoracic intervention: importance of the internal mammary artery.

The anatomic evaluation of internal mammarian artery by using multidetector CT angiography

“…In this procedure, the inadvertent puncture of the IMA is potentially fatal. Glassberg and Sussman (24) reported two cases of life-threatening hemorrhage due to percutaneous transthoracic interventions in 1990. Oh et al (4) reported that above the first rib, there is a safe biopsy window on the majority of sides (70.1%).…”

Guidelines for radiologically guided lung biopsy

“…182 Haemothorax Significant haemothorax is rare but may develop from biopsy procedures through the intercostal or internal mammary arteries. 8 When a large haemothorax develops, the patient should be given supportive care and the clinical team contacted. Signs of this are usually evident within the first hour.…”

CT–guided Transvenous or Transcaval Needle Biopsy of Pancreatic and Peripancreatic Lesions

“…Our technique is slightly different from the technique described in that report; we routinely use a di- rect transcaval approach rather than a coaxial technique. These comprised three of the eight patients with a small amount of bleeding evident on the routine postbiopsy CT. All of these remained asymptomatic, which is not surprising because, although potentially fatal (12), arterial punctures remain asymptomatic and resolve without treatment in most instances (13). If additional samples are necessary, the procedure is repeated.…”