肝癌介入治疗的严重并发症—碘油脑栓塞

The Serious Complication During Transcatheter Arterial Chemoembolization of hepatocellular carcinoma——Cerebral Lipiodol Embolism(CLE)

目的探讨和分析在肝脏介入化疗栓塞中发生碘油脑栓塞的危险因素。方法通过对临床肝脏肿瘤介入治疗中发生碘油脑栓塞病例和相关文献的回顾,分析碘油脑栓塞的发生原因和相关危险因素。结果碘油脑栓塞的发生与肝脏、肺、心脏存在动-静脉交通;肿瘤形成侧支供血动脉特别是膈下动脉参与供血的介入治疗;碘油的用量等因素相关。结论碘油脑栓塞是肝脏肿瘤介入化疗栓塞的少见的严重并发症,发生的主要因素是动-静脉异常交通的存在。

Objective To study the rare complication-cerebral lipiodol embolism （CLE） during or after transcatheter arterial chemoembolization （TACE）, and to analyze the factors involved in this procedure. Methods A clinical case of CLE during TACE and the literature were reviewed to analyze the risk factors of CLE. Results The risk factors of CLE during or after TACE included right to left shunts involved in heart, liver and lung, dilated anastomotic branches especially the carcinomas fed by inferior phrenic artery（IPA）, the amount of lipiodol. Conclusion CLE is a rare and severe complication that may occur during or after TACE, the main risk factor is the presence of arteriovenous shunt（AVS）.