Acute Ischemic Stroke (AIS) Due to Cerebral Lipiodol Embolization (CLE) from Diagnostic Lymphangiography (1747)

Objective: This case report attempts to better understand the impact of AIS from CLE as a complication of lymphangiographic procedures. An evaluation of the possible mechanisms, role of diagnostic studies, management, and overall clinical outcomes was made. Background: Diagnostic lymphangiography is a widely used study to assess for lymphatic duct leaks. CLE is a rare complication of lymphangiographic procedures and can lead to AIS. Although CLE can lead to poor clinical outcomes, the exact mechanisms for AIS caused by CLE remains unclear. Design/Methods: A case summary was presented of a 58 year-old woman with HIV and no history of malignancy presenting with AIS due to CLE following a diagnostic lymphangiogram. A literature review of CLE following lymphangiogram procedures was performed. Results: Not Applicable Discussion: Possible mechanisms of CLE may include direct cytotoxicity or cerebral vasculature occlusion. AIS following CLE may also be due to small vessel pathology. Multiple different imaging modalities may be warranted to fully assess the extent of brain injury from AIS due to CLE. Management for AIS from CLE is unclear and currently remains on supportive care based on an individual case by case basis. Conclusions: CLE following lymphangiography can lead to AIS and cause significant neurological impairment. AIS from CLE may have its own specific mechanism for brain injury compared to other etiologies of AIS. Further evaluation of the role of diagnostic studies, interventions, and overall outcomes should be made for patients suffering from AIS as a result of CLE. Disclosure: Dr. Jang has nothing to disclose. Dr. Kim-Tenser has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Portola Pharmaceuticals and Chiesi USA.