Adjuvant hepatic arterial infusion after curative resection of colorectal liver metastases using removable intra-arterial catheters with shape-memory alloy.
OBJECTIVE
Although there are some reports that adjuvant hepatic arterial infusion (HAI) chemotherapy reduces the hepatic recurrence following curative resection of colorectal liver metastases, problems of indwelling catheters after chemotherapy cessation remains unsolved. The usefulness of adjuvant HAI was investigated using a removable port-catheter system.


METHODS
Spiral catheterstrade mark were attempted to be placed in 17 patients who underwent curative hepatectomy. The catheter contains a special shape-memory alloy at its tip, which allows stable fixation to the vascular wall without coiling so the catheter can be removed if necessary. 5-fluorouracil (5-FU) in total dose of 12 g was intra-arterially administered.


RESULTS
W spiral catheterstrade mark were successfully placed in the hepatic artery by percutaneous approach in 82% of the patients. All patients underwent scheduled chemotherapy without serious adverse events. Reservoir-catheter system was removed easily and uneventfully after discontinuation of the chemotherapy. 3D-CT angiography revealed that the hepatic artery was well preserved with short-term chemotherapy. Postoperative hepatic recurrence was observed only in 18% of the patients with the median follow-up time of 19.9 months.


CONCLUSIONS
Prophylactic 5-FU HAI using W spiral cathetertrade mark and subsequent catheter extirpation is a promising strategy following curative resection of colorectal liver metastases.
Tono
Takeshi
T
Department of Surgery, NTT West Osaka Hospital, Tennoji-ku, Osaka, Osaka, Japan. ttono@zero.ad.jp
Kanoh
Toshiyuki
T
Ohnishi
Tadashi
T
Matsushita
Masaki
M
Nakano
Yoshiaki
Y
Kimura
Yutaka
Y
Iwazawa
Takashi
T
Yano
Hiroshi
H
Okamura
Jun
J
Monden
Takushi
T
D000328:Adult; D000368:Aged; D000497:Alloys; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D002408:Catheters, Indwelling; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D020878:Device Removal; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000295:instrumentation*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014654:Vascular Patency
D000497:Alloys; D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil