pirarubicin and Pulmonary-Embolism

We present a case of pulmonary embolism that occurred during the injection of lipiodol during transcatheter arterial chemoembolization under general anaesthesia. A 7-year-old child suffering from a large hepatoblastoma was admitted for arterial chemoembolization and carcinostatic administration. Pulmonary embolism due to lipiodol during arterial chemoembolization was evident by a sudden fall in oxyhaemoglobin saturation from 100 to 90%. This was associated with a spread of lipiodol into both lungs, particularly the middle lung zones and detected by chest fluoroscopy. Arterial blood gases returned to normal values 1 day later but pulmonary infiltration persisted for 7 days before final clearance. Pulmonary embolism caused by lipiodol during arterial chemoembolization is infrequent, but such a complication could prove fatal. Understanding the risk of pulmonary embolism in patients receiving lipiodol, during and after arterial chemoembolization, and late onset pulmonary injury is important and a close follow-up for several days after arterial chemoembolization is advisable.

Topics: Antibiotics, Antineoplastic; Antineoplastic Agents; Catheterization, Peripheral; Chemoembolization, Therapeutic; Child; Contrast Media; Critical Care; Doxorubicin; Fluoroscopy; Follow-Up Studies; Hepatoblastoma; Humans; Iodized Oil; Liver Neoplasms; Male; Oxygen; Oxyhemoglobins; Positive-Pressure Respiration; Pulmonary Embolism; Radiography, Interventional