Pulmonary complications of transcatheter arterial chemoembolization for hepatocellular carcinoma

• 作者: Catherine T Frenette Harry Knowles Paul J Pockros Quan M Nhu
• 来源期刊: 世界呼吸病学杂志
• 学科: 医学
• 关键词: TRANSCATHETER arterial CHEMOEMBOLIZATION Liver cirrhosis PULMONARY complications Hepatocellular carcinoma ACUTE lung injury ACUTE respiratory distress syndrome PNEUMONITIS PULMONARY oil EMBOLISM
• 年，卷（期）: 2016,（3）
• 页码范围: 69-75
• 页数: 7页
• 分类号: R

摘要

Transcatheter arterial chemoembolization(TACE)is an effective palliative intervention that is widely accepted for the management of hepatocellular carcinoma(HCC).Post-TACE pulmonary complications resulting in acute lung injury(ALI)or acute respiratory distress syndrome(ARDS)are rare events.Pulmonary complications after TACE are thought to be related to chemical injury subsequent to the migration of the infused ethiodized oil or chemotherapeutic agent to the lung vasculature,facilitated by arteriovenous(AV)shunts within the hyper-vascular HCC.We review herein the literature on pulmonary complications related to TACE for HCC.Post-TACE pulmonary complications have included pulmonary oil embolism,interstitial pneumonitis,chemical pneumonitis,ALI,ARDS,lipoid pneumonia,acute eosinophilic and neutrophilic pneumonia,bilious pleuritis,pulmonary abscess,pulmonary tumor embolism,and possibly pulmonary metastasis with HCC.The risk factors associated with post-TACE pulmonary complications identified in the literature include large hyper-vascular HCC with AV shunts,large-volume Lipiodol infusion,and embolization via the right inferior phrenic artery.However,the absence of known risk factors is not a guarantee against serious complications.An astute awareness of the potential post-TACE pulmonary complications should expedite appropriate therapeutic interventions and increase potential for early recovery.