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Summary
Internal iliac artery embolization for cancer complications can cause lower limb paresis due to nerve ischemia. Careful technique and larger embolic materials may reduce this risk.
Area of Science:
- Interventional Radiology
- Oncology
- Neurology
Background:
- Internal iliac artery embolization is used for hemorrhage control and tumor debulking in advanced cancer.
- Potential neurological complications following this procedure are not well-documented.
Observation:
- Three patients with terminal cancer developed extensive lower limb paresis after internal iliac artery embolization.
- Embolic materials caused widespread vessel obliteration in both divisions of the internal iliac artery.
Findings:
- Paresis is attributed to sciatic and femoral nerve ischemia secondary to embolization.
- Previous radiotherapy may have contributed to the neurological deficits.
Implications:
- Selective embolization and precise vessel identification are crucial to prevent nerve damage.
- Using larger embolic materials, such as Gelfoam pledgets, may mitigate risks when selective embolization is not feasible.