Radiologic placement of side-hole catheter with tip fixation for hepatic arterial infusion chemotherapy.
OBJECTIVE
To investigate the technical outcome of radiologic catheter placement with use of a side-hole catheter with distal fixation for hepatic arterial infusion chemotherapy.


METHODS
Between January 1993 and September 1999, 426 patients were referred to our department to undergo intraarterial infusion chemotherapy for unresectable malignant liver tumors. A subclavian artery was exposed under local anesthesia and a catheter was inserted. After inserting the tip of the side-hole catheter into the gastroduodenal artery, splenic artery, or peripheral branch of the hepatic artery, the catheter tip was fixed to the vessel with use of coils and a mixture of n-butyl cyanoacrylate (NBCA) and iodized oil. The proximal end of the catheter was connected to an implanted port, and the port system was embedded subcutaneously.


RESULTS
Placement was successful in 425 of 426 patients (99.8%) in a mean time of 76 minutes. Catheter dislodgement was noted in 12 patients (2.8%). Cumulative patency rates of the hepatic artery calculated according to the Kaplan-Meier method for the entire group were 91.0%, 81.4%, and 58.1% at 6 months and 1 and 2 years, respectively. Complications related to catheter placement were observed in nine cases and included dysfunction of the implanted system (n = 3), significant bleeding around the implanted port (n = 2), improper infusion of NBCA and iodized oil (n = 2), and cerebral infarction (n = 2).


CONCLUSIONS
Radiologic catheter placement via a subclavian artery with side-hole catheter placement with distal fixation for hepatic arterial infusion chemotherapy is a highly successful procedure with a reduced risk of catheter dislodgment and arterial occlusion.
Tanaka
Toshihiro
T
Department of Diagnostic and Interventional Radiology, Aichi Cancer Center, Nagoya, Japan.
Arai
Yasuaki
Y
Inaba
Yoshitaka
Y
Matsueda
Kiyoshi
K
Aramaki
Takeshi
T
Takeuchi
Yoshito
Y
Kichikawa
Kimihiko
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology*; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D015179:Colorectal Neoplasms / Q000473:pathology*; D004659:Enbucrilate; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D007459:Iodized Oil; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D013157:Splenic Artery
D000970:Antineoplastic Agents; D007459:Iodized Oil; D004659:Enbucrilate