Serious Damage Following Carotid Angiography with Thorotrast

Abstract

Thorotrast, a roentgen contrast medium containing radio-active thorium dioxide, was used for investigations including hepato-splenography and especially arteriography during the years 1930-1945, roughly speaking. The substance remains permanently in the patient's body, and may give rise to generalized and localized lesions, including malignant tumours.

Four cases, 2 of them fatal, of lesions, the late sequelae of accidental extravascular injection of thorotrast during carotid angiography are described. Clinical signs included cranial nerve palsies and ulceration of the pharynx. In one of the patients fibrosarcoma and mesothelioma were present in the vicinity of a thorotrast granuloma.

An unknown number of persons are still going about with thorotrast depots in their bodies, and it is possible that thorotrast damage may still be encountered for 30 or 40 years to come.