Multiple hepatic infarction after transcatheter arterial infusion with SMANCS

We report a patient with hepatocellular carcinoma who developed multiple he patic infarction after transcatheter arterial infusion (TAI) with a suspens ion of styrene maleic acid neocarzinostatin (SMANCS) and Lipiodol (SMANCS/L ipiodol). The parameters of hepatic functional reserve were apparently decr eased after the second TAI with SMANCS/Lipiodol, and the patient died of he patic failure 103 days after the second TAI. The autopsy liver specimen rev ealed multiple hepatic infarctions associated with peripheral arterial sten osis or occlusion, and portal thrombosis. It is speculated that both the ar terial occlusion and the portal thrombosis caused the hepatic infarction, b ased on a long-term insufficiency of blood supply to the hepatocytes arisin g from toxic arteritis caused by SMANCS/Lipiodol.