title: Cerebral iodized lipid embolization via a pulmonary arteriovenous shunt: rare complication of transcatheter arterial embolization for hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Bánsághi
authors.forename: Pál Novák
authors.initials: PN
authors.lastname: Kaposi
authors.forename: Gábor
authors.initials: G
authors.lastname: Lovas
authors.forename: Gyöngyvér
authors.initials: G
authors.lastname: Szentmártoni
authors.forename: György
authors.initials: G
authors.lastname: Várallyay
authors.forename: Pál
authors.initials: P
authors.lastname: Bata
authors.forename: Ildikó
authors.initials: I
authors.lastname: Kalina
authors.forename: Balázs
authors.initials: B
authors.lastname: Futácsi
authors.forename: Viktor
authors.initials: V
authors.lastname: Bérczi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D001166:Arteriovenous Shunt, Surgical; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000628:therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D004998:Ethiodized Oil / Q000008:administration & dosage*; D017809:Fatal Outcome; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil