Cerebral iodized lipid embolization via a pulmonary arteriovenous shunt: rare complication of transcatheter arterial embolization for hepatocellular carcinoma

We report the first European case of cerebral iodized lipid embolism post transcatheter arterial embolization for hepatocellular carcinoma. Lipiodol emboli and corresponding multifocal brain ischemia were documented with computed tomography (CT) and magnetic resonance (MR) in the acutely symptomatic...

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Bibliographic Details
Published in:World journal of surgical oncology 2013-05, Vol.11 (1), p.122-122, Article 122
Main Authors: Bánsághi, Zoltán, Kaposi, Pál Novák, Lovas, Gábor, Szentmártoni, Gyöngyvér, Várallyay, György, Bata, Pál, Kalina, Ildikó, Futácsi, Balázs, Bérczi, Viktor
Format: Article
Language:English
Subjects:
Antineoplastic Agents - administration & dosage
Arteriovenous Shunt, Surgical
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - therapy
Care and treatment
Case Report
Case studies
Catheterization
Complications and side effects
Diagnosis
Embolization, Therapeutic - adverse effects
Ethiodized Oil - administration & dosage
Fat embolism
Fatal Outcome
Hepatoma
Humans
Intracranial Embolism - etiology
Intracranial Embolism - therapy
Liver Neoplasms - complications
Liver Neoplasms - therapy
Male
Middle Aged
Patient outcomes
Pulmonary Artery - abnormalities
Pulmonary Veins - abnormalities
Risk factors
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Summary:We report the first European case of cerebral iodized lipid embolism post transcatheter arterial embolization for hepatocellular carcinoma. Lipiodol emboli and corresponding multifocal brain ischemia were documented with computed tomography (CT) and magnetic resonance (MR) in the acutely symptomatic patient. Transcranial Doppler sonography with contrast indicated a right-to-left shunt, while on a follow-up CT scan lipiodol embolization was detected in both lungs. Dilated pulmonary vessels and thick vascular channels were seen in the vicinity of the right diaphragm suggestive of pulmonary arteriovenous shunt. The patient symptoms regressed with supportive care alone, but he died 5 months later due to hepatic failure unrelated to the procedure.
ISSN:1477-7819
1477-7819
DOI:10.1186/1477-7819-11-122