Percutaneous implantation of arterial Port-a-cath via trans-subclavin access.
BACKGROUND
Hepatic artery infusion is the best choice of treatment for colorectal liver metastases, but it could be suggested for other hepatic tumors or locally advanced pancreatic cancer. The need of a laparotomy for the positioning of the arterial catheter has been the limiting factor for the diffusion of regional treatments.


METHODS
170 patients suffering from primary or secondary liver tumours and pancreatic or bile ducts cancer, underwent the positioning of intra-arterial hepatic part-a-cath by a transcutaneous subclavian access in local anaesthesia. In 163 patients, a catheter was placed into the hepatic artery, 4 into the splenic and 3 into the gastroduodenal artery.


RESULTS
The procedure was performed successfully in all patients. We observed 5 aneurysms of the subclavian artery and 9 thrombosis of the hepatic artery. Only in 7 patients was arterial infusion suspended for technical complications. We observed 10.6% of dislocation, but dislodged catheters were always moved again into the hepatic artery.


CONCLUSIONS
The development of percutaneous techniques of arterial port-a-cath implantation could enlarge the indication of regional chemotherapy.
Zanon
C
C
Service of Surgical Oncology, University of Turin, Molinette Hospital, Torino, Italy. zanoncl@tin.it
Grosso
M
M
Clara
R
R
Chiappino
I
I
Mancini
A
A
Mussa
A
A
D000783:Aneurysm / Q000209:etiology; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013157:Splenic Artery; D013348:Subclavian Artery; D013927:Thrombosis / Q000209:etiology
D000970:Antineoplastic Agents