Correlation between postoperative sudden death and hepatic vein 'lipiodol tram-track sign' occurring in the performance of arterial embolization for liver cancer

Objective: To discuss the correlation between postoperative sudden death and hepatic vein 'lipiodol tram-track sign' that occurs during the performance of arterial embolization for liver cancer. Methods: During the period from Jan. 2010 to Oct. 2013, a total of 5372 times of arterial embolization for liver cancer were carried out at Beijing Shijitan Hospital. The occurrence of sudden death within 48 hours after the treatment and the incidence of hepatic vein 'lipiodol tram-track sign' were recorded, and the correlation between postoperative sudden death and hepatic vein 'lipiodol tram-track sign' was evaluated. Results: Sudden death within 48 hours after the treatment occurred in 7 patients, accounting for 0.095% of the total patients. During the performance of arterial embolization, hepatic vein 'lipiodol tram-track sign' was detected in 5 cases. Besides, among 5365 patients who were alive within 48 hours after the embolization therapy, hepatic vein 'lipiodol tram-track sign' was found in 4 cases, accounting for 0.07% of the alive patients. The difference between the two groups was statistically significant (P = 0.00). Conclusion: The possibility of postoperative sudden death occurring within short period after arterial embolization for liver cancer is higher in the patients who shows hepatic vein 'lipiodol tram-track sign' during the performance of arterial embolization. The occurrence of 'lipiodol tram - track sign' should be regarded as a warning to physician that proper and urgent prevention measures as well as therapeutic scheme needs to be formulated in order to prolong the patient's survival time. (authors)