title: Prognosis of cerebral lipiodol embolism caused by transarterial chemoembolization.
abstract: OBJECTIVE
  Transarterial chemoembolization (TACE) plays an essential role in the management of unresectable hepatocellular cell carcinoma and other hepatic neoplasms. Cerebral lipiodol embolism (CLE) is a rare complication of TACE and its prognostic factors have not been well studied. The aim of this paper was to elucidate the prognostic factors of CLE based on clinical data obtained from our patients and cases published since 2004.
  
  
  METHODS
  We present two patients with CLE, analyze the clinical data, and review all CLE cases published since 2004. A poor outcome was defined as stupor, coma, quadriplegia, or death within 45 days. Patients who had other neurological conditions within 45 days were considered as having a good outcome.
  
  
  RESULTS
  The rate of poor outcome was 25.7% (9/35). Compared with the patients with good outcome, those with poor outcome were older (mean age 68.3 ± 7.3 vs. 58.3 ± 10.6 years, p = 0.03), more often female (76.9% vs. male 33.3%, p = 0.02), and more likely chemoembolized via both the right hepatic and right inferior phrenic arteries (44.4 vs. 8.7%, p = 0.02).
  
  
  CONCLUSIONS
  The prognosis of CLE was related to age, gender, and the arteries selected for injection.
authors.affiliation: a Neurological Institute , Taichung Veterans General Hospital , Taiwan , ROC.
authors.forename: Yen-Wei
authors.initials: YW
authors.lastname: Pai
authors.affiliation: a Neurological Institute , Taichung Veterans General Hospital , Taiwan , ROC.|b Department of Applied Chemistry , National Chi Nan University , Taiwan , ROC.
authors.forename: Peiyuan F
authors.initials: PF
authors.lastname: Hsieh
authors.affiliation: a Neurological Institute , Taichung Veterans General Hospital , Taiwan , ROC.
authors.forename: Hsin
authors.initials: H
authors.lastname: Tung
authors.affiliation: c Department of Internal Medicine , Taichung Veterans General Hospital , Taiwan , ROC.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Wu
authors.affiliation: d Department of Electrical Engineering , National Chi Nan University , Taiwan , ROC.
authors.forename: Congo T S
authors.initials: CT
authors.lastname: Ching
authors.affiliation: a Neurological Institute , Taichung Veterans General Hospital , Taiwan , ROC.
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D004998:Ethiodized Oil; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging
chemical_list: D004998:Ethiodized Oil
keywords: Cerebral lipiodol embolism; Hepatocellular carcinoma; Prognosis; Transarterial chemoembolization