Lipiodol

Lipiodol, also known as ethiodized oil, is a poppyseed oil used by injection as a radio-opaque contrast agent that is used to outline structures in radiological investigations.[1][2] It is used in chemoembolization applications as a contrast agent in follow-up imaging.[3] Lipiodol is also used in lymphangiography, the imaging of the lymphatic system.[4] It has an additional use in gastric variceal obliteration as a dilutant that does not affect polymerization of cyanoacrylate.

Lipiodol
Clinical data
Trade namesLipiodol
AHFS/Drugs.comInternational Drug Names
License data
Routes of
administration		Intralymphatic, intrauterine, intra-arterial
ATC code
  • none
Legal status
Legal status
  • AU: S4 (Prescription only)
  • US: ℞-only
Pharmacokinetic data
Excretion 
Identifiers
CAS Number
ChemSpider
  • none
UNII
ChEMBL
ECHA InfoCard100.122.502

Indications

Recently, there has been an increasing interest in the use of Lipiodol as a therapeutic agent in the management of unexplained infertility, using a procedure called Lipiodol flushing. There have been a small number of studies that suggest that flushing the media through the tubes gives a short-term rise in fecundity in patients with unexplained infertility. A systematic review has suggested a significant increase in fertility, especially in those women who have endometriosis when using Lipiodol flushing.[5]

Historically Lipiodol was often used as a contrast medium at hysterosalpingography (HSG: a procedure to determine tubal patency, used in the investigation of subfertility). It became less commonly utilized in the 1960s to 1980s because the more modern water-soluble media give images that are easier to interpret. There is also an important safety issue with Lipiodol in that intravasation (leakage) of the fluid into the venous system has caused complications in the past.

Composition

Ethiodized oil is composed of iodine combined with ethyl esters of fatty acids of poppyseed oil, primarily as ethyl monoiodostearate and ethyl diiodostearate. The precise structure is not known.

History

Lipiodol was first synthesized by Marcel Guerbet in the Paris School of Pharmacy in 1901. Historically, Lipiodol was the first iodinated contrast agent (used for myelography by two French physicians, Jacques Forestier and Jean Sicard in 1921).

Lipiodol or ethiodized oil for interventional procedure, was solely produced and marketed by Guerbet until Vivere Imaging launched its ethiodized oil in the brand name Vividol in 2022.

References
  1. Ahrar K, Gupta S (January 2003). "Hepatic artery embolization for hepatocellular carcinoma: technique, patient selection, and outcomes". Surgical Oncology Clinics of North America. 12 (1): 105–26. doi:10.1016/s1055-3207(02)00089-3. PMID 12735133.
  2. Sato T (April 2002). "Locoregional immuno(bio)therapy for liver metastases". Seminars in Oncology. 29 (2): 160–7. doi:10.1053/sonc.2002.31716. PMID 11951214.
  3. Guan YS, Hu Y, Liu Y (June 2006). "Multidetector-row computed tomography in the management of hepatocellular carcinoma with transcatheter arterial chemoembolization". Journal of Gastroenterology and Hepatology. 21 (6): 941–6. doi:10.1111/j.1440-1746.2006.04474.x. PMID 16724976. S2CID 40066693.
  4. Cabanas RM (2000). "The concept of the sentinel lymph node". Recent Results in Cancer Research. Fortschritte der Krebsforschung. Progres dans les Recherches Sur le Cancer. Recent Results in Cancer Research. 157: 109–20. doi:10.1007/978-3-642-57151-0_9. ISBN 978-3-642-63070-5. PMID 10857165.
  5. Johnson NP (2005). "A review of the use of lipiodol flushing for unexplained infertility". Treatments in Endocrinology. 4 (4): 233–43. doi:10.2165/00024677-200504040-00004. PMID 16053340. S2CID 25322807.
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