Percutaneous transfemoral hepatic arterial infusion catheter placement with the use of a downsized coaxial catheter system: technical feasibility study.
OBJECTIVE
In transfemoral implantation of a conventional port-catheter system for hepatic arterial infusion chemotherapy, there is a risk of pericatheter bleeding as a result of a caliber difference between the indwelling catheter and introducer sheath. The purpose of this study was to evaluate the feasibility and safety of a single-operator catheter exchange maneuver with a downsized system that includes a 3-F sheath.


METHODS
Sixteen patients (15 men; mean age, 67 years) with unresectable liver cancer underwent percutaneous port-catheter placement. A system consisting of a 2-F microcatheter, 3.3-F diagnostic catheter, and 3-F sheath was used to perform mapping diagnostic visceral arteriography and microcoil embolization for redistribution of flow. Catheter exchange with a 5-F indwelling catheter (W-Spiral catheter) was performed, and the tip of a W-Spiral catheter was inserted into the right gastroepiploic artery. The technical success of this single-operator catheter exchange, postprocedural complications, and performance of one-step or multistep catheter exchange procedures were evaluated.


RESULTS
Percutaneous port-catheter placement by a single operator with use of a downsized system was successful and safe in all patients (100%). Eight of 16 patients (50%) required multistep catheter exchange or dilation with two different guide wires because of arteriosclerosis, whereas the other eight underwent catheter exchange with a single guide wire.


CONCLUSIONS
Percutaneous port-catheter placement with use of a downsized system offers potential clinical advantages of safety and simplified catheter exchange.
Tajima
Tsuyoshi
T
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ttajima@med.kyushu-u.ac.jp
Yoshimitsu
Kengo
K
Irie
Hiroyuki
H
Nishie
Akihiro
A
Hirakawa
Masakazu
M
Ishigami
Kousei
K
Ushijima
Yasuhiro
Y
Okamoto
Daisuke
D
Kida
Munechika
M
Kurogi
Rinya
R
Honda
Hiroshi
H
Kuroiwa
Toshirou
T
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002408:Catheters, Indwelling; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000295:instrumentation* / Q000379:methods; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*
D000970:Antineoplastic Agents