Pulmonary lipiodol embolism

Inadvertent pulmonary lipiodol embolism during TACE has been reported in adults [54] and children [55],... 

Yamaura K, Higashi M,Akiyoshi K,et al. (2000) Pulmonary lipiodol embolism during transcatheter arterial chemoembolization for hepatoblastoma under general anaesthesia. Eur J Anaesthesiol 17 704-708... 

Iodized oil, at one time widely used, caused less pain but was suspected of causing adhesions and there was certainly some risk of oil embolism after intravasation, for example retinal embolism with visual impairment lasting for some months and several cases of pulmonary oil embolism (SEDA-16, 537). Skin testing with iodized oil on occasion resulted in both local and generalized reactions. Like later agents, lipiodol could also cause salpingitis. 

Kishi et al. (169)evaluated the acute toxicity of Lipiodol infusion into the hepatic arteries (HAD of beagles and found the influence of Lipiodol HAI to be dose dependent. The infused Lipiodol first passed through an arterioportal communication and distributed through the hepatic sinusoids to pulmonary capillaries and thence into systemic blood circulation. The circulation and embolization of oil droplets were found in the renal tubular cells of supracapsular cortex, the choroid plexus, the vascular endothelium, and the pancreatic duct epithelium, showing a process of intracellular collection of Lipiodol from the systemic blood circulation and of further metabolism-provoking cellular reactions. 

A 36-year-old man had a pulmonary embolus after percutaneous embolization of a varicocele with enbucrilate (Histoacryl ) -I- lipiodol [26 ]. 

A 46-year-old woman had an internal iliac arteriovenous malformation obliterated using enbucrilate mixed with lipiodol and 3 days later had a pulmonary embolism [33 ]. 

An 11-year-old boy had fundal varices injected with enbucrilate plus lipiodol and soon afterwards developed hypotension and bradycardia associated with a pulmonary embolism [34 ]. 

Prytula A, Veereman-Wauters G, Duval EL. Pulmonary embolism due to injection of Histoacryl and Lipiodol during endoscopic sclerotherapy of fundic varices. Acta Gastroenterol Belg 2008 71(4) 387-9. 

Transarterial chemoembolization was performed using an endovascular balloon catheter introduced into the segmental pulmonary arteries for super-selective injection of the chemotherapeutic drugs lipiodol and microspheres, while the inflated balloon prevented backflow of embolic material into the main pulmonary artery. A mean decrease in tumor volume of 56.8% was found as a response to treatment It might well be a promising treatment modality in the future after it has been adequately developed to provide maximum effectiveness (Vogl et al. 2005). 

---