经导管动脉化疗栓塞术治疗肝细胞癌致碘化油肺、脑栓塞.pdfVIP

ngT · 221 · 中国介入影像与治疗学 2010年第 7卷第 3期 ChinJIntervImagi — — her,2 1 11! Pulmonaryandcerebrallipiodolembolism duringtranscatheter arterialchemoembolization in thetreatment 0fhepat0cellularcarcinoma CHANGYong—chuang，NJCai—fang ，LIUYi—zhi，ZOUJian—wei，CHEN Long (DepartmentofInterventionalRadiology，theFirstAffiliatedHospitalof Soochow University，Suzhou215006，China) [Abstract] 0bjective Toanalyzethecausesandmechanism ofpulmonaryandcerebrallipiodolembolism duringtran— scatheterarterialchemoembolization (TACE)inpatientswithheDatocellularcarcinoma (HCC)，andtodiscussthecorre- spondingpreventiveandtherapeuticmeasures．Methods Pulmonaryandcerebrallipiodolembolism occuredin 3patients withHCC duringTACE，thecausesandmechanism wereanalyzedwithreview ofrelativeliteratures，inordertofindout correspondingpreventiveandtherapeuticmeasures．Results ThreepatientswereallinvolvedinmassiveHCC．Thefirst patient，a71～year-oldwoman，died1yearaftercerebrallipiodolembolism resultedfrom thethird timeofTACE．Acute dyspneaandunconsciousnessdevelopedintheother2malepatients，followingtheprocedureduetopulmonaryandcerebral lipiodolembolism whenthesecondandthirdtimeofTACEwasperformed，respectively．Thechestconditionandconscious stateofbothpatientswereimprovedafterpositiveemergencytreatment．Literatureshadreportedthat6patientsofcerebral lipiodolembolism wereinvolvedinembolism viainferiorphrenicartery．Conclusion Pulmonaryandcerebrallipiodolem— bolism israreandseverecomplicationofTACE．Themostprobablemechanismsofpulmonaryandcerebrallipiodolembol— ism arethetumor’Sfeedingarteriescomingfrom intercostalarteryand／orinferiorphrenicartery，excessivelipiodolusage andopeni