Multiple hepatic infarction after transcatheter arterial infusion with SMANCS.
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.
Abe
S
S
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu.
Yamasaki
T
T
Nakano
K
K
Yoshikawa
I
I
Tabaru
A
A
Otsuki
M
M
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000188:drug therapy*; D002404:Catheterization; D003287:Contrast Media / Q000627:therapeutic use; D006801:Humans; D007238:Infarction / Q000139:chemically induced* / Q000209:etiology; D007261:Infusions, Intra-Arterial / Q000295:instrumentation*; D007459:Iodized Oil / Q000627:therapeutic use; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008299:Maleic Anhydrides / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011137:Polystyrenes / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D009353:Zinostatin / Q000008:administration & dosage* / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D003287:Contrast Media; D008299:Maleic Anhydrides; D011137:Polystyrenes; C035755:poly(maleic acid-styrene)neocarzinostatin; D007459:Iodized Oil; D009353:Zinostatin