General anesthesia was performed and then a 4 cm incision was made at the pivot of the fourth intercostal space and the anterior axillary line. Even if the hook wire was still required to be in the pulmonary parenchyma, it should be fixed to the pleural by a titanic clip or a hemolock clip. At the beginning of the operation, the hook wire might as well be removed first. Conclusionsĭuring localization procedure, the tip of hook wire should be far from pulmonary vessels. The patient was eventually recovered and discharged. With the help of vascular surgery department, the hook wire was extracted by interventional therapy under digital substraction angiography (DSA). During the operation, the hook wire unexpectedly slided into left upper lobe pulmonary artery. Since it might be difficult to identify the ground-glass opacity located in the right lower lobe, a CT-guided hook wire was placed before surgery. Case presentationĪ 61-year-old male suffered from multiple pulmonary nodules received right upper lobectomy and right lower lobe wedge resection by video-assisted thoracic surgery (VATS) 3 months ago. However, sliding into pulmonary artery is an extremly rare comlication of hook wire localization. CT-guided hook wire has been recognized to be a safe and effective percutaneous localizer to identify small pulmonary lesions with ground-glass opacity (GGO) component, while several association complications including pneumothorax, hemothorax, intrapulmonary hemorrhaging, aeroembolism and dislodgement have been reproted.

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