Arterial port catheter system placement using a translumbar aortic route.
OBJECTIVE
Implantable ports for arterial infusion hold promise in a growing number of clinical applications, including regional chemotherapy and gene therapy. Percutaneous placement of arterial infusion ports has been described clinically; however, existing sites of access pose unique anatomic challenges. The feasibility of translumbar aortic placement of a port-catheter system for long-term arterial infusion was assessed.


METHODS
Eight swine underwent placement of a percutaneously implantable arterial port-catheter system using a translumbar aortic approach for catheter placement. The tip of the catheter was positioned in the left or right hepatic artery and the port reservoir implanted in the paraspinal subcutaneous tissues. Patency and position of the port-catheter system were assessed at 7 to 10 days and 28 days. The insertion procedure was modified in two animals by introducing tissue adhesive around the catheter to prevent dislodgment.


RESULTS
Immediate technical success was achieved in 6 of 8 animals (75%). Catheters were dislodged into the aorta in two animals on the day of the procedure, extravascular in four animals and intra-aortic in one animal by day 10. One animal died at 21 days of sepsis. The port-catheter systems remained functional at 28 days with catheters positioned within the left or right hepatic artery in three animals, including two animals in which the catheter had been fixated within the paraspinal soft tissues with tissue adhesive.


CONCLUSIONS
A translumbar aortic route for percutaneous placement of arterial infusion port-catheter systems is feasible in swine and holds potential as an ancillary access site in a clinical setting if the obstacle of catheter fixation can be overcome.
Clark
Timothy W I
TW
Department of Radiology, Dalhousie University, Halifax, Canada. clark@oasis.rad.upenn.edu
Bilo
John M
JM
Beecroft
J Robert
JR
D000818:Animals; D001012:Aorta, Abdominal; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D005240:Feasibility Studies; D006499:Hepatic Artery; D013552:Swine