Pulmonary complications of transcatheter arterial chemoembolization for hepatocellular carcinoma

Table 1 Case series and original studies of post-transarterial chemoembolization pulmonary complications

Ref.	Time	No.	Infusion	Pulmonary complications	Onset	Risk factors
Chung et al[42]	01/1990-12/1991	336 patients	Iodized oil (3-40 mL) with Doxorubicin (20-60 mg)	Any pulmonary symptoms: 11 (3.27%) Pulmonary oil embolism: 6 (1.79%) Death: 1 (0.3%)	2-5 d	Iodized oil > 20 mL
Tajima et al[44]	06/1997-05/1999	44 patients	Lipiodol (0-10 mL) with Doxorubicin derivatives (0-50 mg)	Dyspnea or hemoptysis: 2 (4.5%)	–	Via right inferior phrenic artery
Sakamoto et al[45]	1998	850 patients 2300 procedures	Iodized oil (2-15 mL) with drug mix, including Doxorubicin (10-30 mg)	Pulmonary oil embolism: 4 (0.17%)	–	Via right inferior phrenic artery
Xia et al[59]	01/1997-02/2004	1348 patients 2012 procedures	Lipiodol (5-40 mL) with Chemotherapeutic agents	Pulmonary oil embolism: 1 (0.05%)	6 h	Lipiodol 25 mL infusion
Wu et al[41]	01/2005-12/2008	219 patients	Lipiodol (4-50 mL) with Doxorubucin (6-60 mg)	Pulmonary oil embolism: 20 (9.1%) Death: 5 (2.3%)	–	Lipiodol > 14.5 mL
Wu et al[60]	01/2006-12/2006	89 patients	Lipiodol (4-50 mL) without or with Doxorubicin (6-60 mg)	Pulmonary oil embolism: 4 (4.5%)	1 h-4 d	Lipiodol 20-50 mL infusion
Xu et al[40]	01/2010-03/2012	478 patients 1026 procedures	Iodized oil (10-40 mL) with Epirubicin (20-60 mg)	Pulmonary oil embolism: 11 (2.3%) Death: 3 (0.6%)	0 h-2 d	Tumor size > 10 cm Lipiodol > 20 mL

Table 2 Post-transarterial chemoembolization pulmonary complications

Post-TACE pulmonary complications	Ref.
Pulmonary oil embolism	Lin et al[43]
	Weng et al[61]
	References from Table 1
Interstitial pneumonitis	Adaddin et al[57]
Chemical pneumonitis	Kwok et al[62]
ALI/ARDS	Khan et al[56]
	Samejima et al[63]
	Czauderna et al[64]
	Hatamaru et al[47]
	Toro et al[65]
	Wu et al[60]
	Nhu et al[1]
Lipoid pneumonia	Taupin et al[55]
Acute eosinophilic and neutrophilic pneumonia	Alifakioti et al[58]
Bilious pleuritis	Ichikawa et al[66]
Pulmonary abscess	Cubiella et al[67]
Pulmonary tumor embolism	Kwok et al[62]
Pulmonary metastasis with HCC	Liou et al[49]

TACE: Transarterial chemoembolization; ALI: Acute lung injury; ARDS: Acute respiratory distress syndrome; HCC: Hepatocellular carcinoma.