Cerebral lipiodol embolism after transarterial chemoembolization in the treatment of primary liver cancer:report of two cases with literature review

Objective To analyze the cause of cerebral lipiodol embolism(CLE) after transarterial chemoembolization(TACE) in patient with primary liver cancer,and investigate the preventive strategies of CLE.Methods We present 2 cases of cerebral lipiodiol embolism that occurred after TACE,together with 34 cases from literatures,to analyze the cause and mechanism of CLE after TACE.Results Totally 36 cases were analyzed,in which ten of them occurred with CLE more than forth times of TACE(27.8%),19(52.8%) infused more than 20 ml lipiodol,and 15(41.7%) were with huge tumor.Conclusion Cerebral lipiodol embolism is a rare and severe complication of TACE.The most probable causing factors of cerebral lipiodol embolism are the intervention therapy times,the dose of lipiodol,the size of tumor and the abnormal tumor feeding arteries.It is vitally important to prevent cerebral lipiodol embolism during TACE.Once cerebral embolism occurred,the positive emergency treatment must be immediately performed.