Pulmonary And Cerebral Lipiodol Embolism After Transcatheter Arterial Chemoembolization Of Hepatocellular Carcinoma

Objective: To review the cases of Pulmonary and Cerebral Lipiodol Embolism after TACE of Hepatocellular Carcinomas.And Analyze the mechanism,risk factors and corresponding treatment and preventive measures.Methods: To search articles with formulary terms,then Inclusion and exclusion of articles according to relevant standards,and Put all observations together into analyses.Results:22 articles and 64 cases were included.Among them,41 cases of pulmonary lipiodol embolism,23 cases of cerebral lipiodol embolism.In the patient of pulmonary lipiodol embolism,31 patients were involved in massive HCC,12 patients had arteriovenous fistula.in 21 cases,more than 20 ml of lipiodol was administererd.The main symptom of patient were cough,hemoptysis,tachypnea,dyspnea.The imaging findings were chest radiograph have diffuse bilateral pulmonary parenchymal infiltrates or CT presence of high density of lipiodol.In the patient of Cerebral lipiodol embolism,9 patients were involved in massive HCC,3 patients had arteriovenous fistula.in 14 cases,more than 20 ml of lipiodol was administered.The main symptom of patient were nonspecifc cerebral ischemia symptoms,such as headache,coma,limb paralysis.The imaging were the unique pattern of diffuse hyperdensity lesions on non-contrast head CT or head MRI shows hyperintense signal of lipiodol.Conclusion: Pulmonary and Cerebral lipiodol embolism are rare complications of TACE.Clinicians should improve their understanding of them,Stress should be put on the prevention,and have Active treatment.