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

Image-guided percutaneous transthoracic procedures such as needle biopsy of lung or mediastinal lesions and drainage of pleural fluid collections are now well accepted [1 -7]. These procedures are usually performed safely, although complications can occur, the most common of which are pneumothorax, bleeding, and hemoptysis. In our review of the literature, the internal mammary artery has never been the source of major hemorrhage complicating one of these procedures. In fact, no mention is made of the internal mammary artery as a source of potential bleeding when planning biopsy or drainage routes. We report two cases of life-threatening hemorrhage due to bleeding from this vessel after percutaneous biopsy and intervention.