Multiple hepatic infarction after transcatheter arterial infusion with SMANCS

Abstract

We report a patient with hepatocellular carcinoma who developed multiple hepatic infarction after transcatheter arterial infusion (TAI) with a suspension of styrene maleic acid neocarzinostatin (SMANCS) and Lipiodol (SMANCS/Lipiodol). The parameters of hepatic functional reserve were apparently decreased after the second TAI with SMANCS/Lipiodol, and the patient died of hepatic failure 103 days after the second TAI. The autopsy liver specimen revealed multiple hepatic infarctions associated with peripheral arterial stenosis or occlusion, and portal thrombosis. It is speculated that both the arterial occlusion and the portal thrombosis caused the hepatic infarction, based on a long-term insufficiency of blood supply to the hepatocytes arising from toxic arteritis caused by SMANCS/Lipiodol.

Molecular Genetic Advances in Cardiovascular Medicine

“…The same question can be raised for highly proliferating organs including the skin, the intestine, the liver, and the spleen. Occlusion of dermal arteries in the skin, mesenteric artery in the intestine, hepatic artery in the liver, and splenic artery in the spleen all result in infarcts of the supplied tissue [35][36][37][38] similar to what happens in the heart or in the brain, the two most recently discovered self-renewing organs. 29,39 The inevitable evolution in all these cases is the formation of a scar.…”