Intraarterial infusion therapy via a subcutaneous port for limb-threatening ischemia: a pilot study.
OBJECTIVE
To present the initial results of a new percutaneously implantable catheter port system (PIPS) used for long-term intraarterial infusion therapy in patients with severe ischemic limb disease.


METHODS
Ten patients with deep, extended ischemic ulcerations (all 10) and osteomyelitis (6/10) of the foot received intraarterial infusions of prostaglandine E1 and antibiotics, if indicated, via a new port catheter system with the port placed subcutaneously above the groin after percutaneous introduction and the catheter tip placed into the superficial or deep femoral artery.


RESULTS
Port implantation and repeated port access were uncomplicated. During the follow-up period (mean 11 months, range 1 week-50 months), port migration, leakage, or infection was not observed. Three catheters thrombosed and were opened by fibrinolysis with recombinant tissue plasminogen activator instilled via the port. Treatment success was achieved in 8 patients: relief from rest pain (8 patients), reduction of ulcer size (4/8), and complete healing (4/8). Limb savage rate was 80%. In 2 patients amputation could not be avoided.


CONCLUSIONS
Selective long-term arterial infusion therapy presents a valuable therapeutic regimen for limb salvage. With the new catheter port system, repeated local intraarterial infusion is safe and simple.
Strecker
E P
EP
Department of Radiology, Diakonissen Hospital, Diakonissenstrasse 28, D-76199 Karlsruhe, Germany.
Ostheim-Dzerowycz
W
W
Boos
I B
IB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery; D005528:Foot / Q000098:blood supply; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D000527:Alprostadil