title: Radiologic removal and replacement of port-catheter systems for hepatic arterial infusion chemotherapy.
abstract: OBJECTIVE
  The purpose of our study was to retrospectively evaluate the safety and efficacy of radiologic removal and replacement of port-catheter systems.
  
  
  METHODS
  Between January 1999 and December 2004, 532 patients with unresectable advanced liver cancer underwent radiologic placement of port-catheter systems at our institution. Of these, 18 patients (nine men and nine women; age range, 32-83 years; mean age, 53.8 years) underwent removal of an implanted port-catheter system via the right femoral artery and radiographically guided replacement with a new system to allow continuous hepatic arterial infusion chemotherapy; we retrospectively reviewed these 18 cases. The reasons for removal of the previously implanted systems were as follows: catheter dislodgement (n = 15), catheter obstruction (n = 1), infection related to the implanted port (n = 1), and hemodynamic change (n = 1). Digital subtraction angiography and CT were performed, usually during injection of contrast medium through the implanted port-catheter system, within a few days after the replacement procedure and every 3 months thereafter.
  
  
  RESULTS
  We successfully performed radiologic removal and replacement of the portcatheter system while the patient was under local anesthesia in all 18 patients without complications requiring treatment. The cumulative patency rates of the hepatic artery after removal of the old port-catheter system and replacement with a new port-catheter system were 87.8% and 64.1% at 6 months and 1 year, respectively. Hepatic arterial infusion chemotherapy after replacement was performed 0-68 times (median, 19 times).
  
  
  CONCLUSIONS
  When an implanted port-catheter system can no longer be used but the patency of the hepatic artery is confirmed and continuous hepatic arterial infusion chemotherapy is required, removal and replacement of the port-catheter system are recommended.
authors.affiliation: Department of Interventional and Diagnostic Radiology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Iguchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamaura
authors.forename: Yozo
authors.initials: Y
authors.lastname: Sato
authors.forename: Masaya
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimamoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed