title: Introducing the coaxial method of catheter port implantation for hepatic arterial infusion chemotherapy.
abstract: BACKGROUND
  Hepatic arterial infusion chemotherapy (HAIC) is an effective method of treating patients with liver metastasis. However, in patients who have tortuous hepatic arteries, the procedure is extremely difficult with currently available methods. We have hence devised a method that is applicable in technically difficult circumstances called the coaxial method of cannulation.
  
  
  RESULTS
  When compared to the conventional method of cannulation for HAIC, the coaxial method does not involve catheter exchange. This process is often associated with the flimsy micro-guide wire dislodging out of the target artery, particularly if the patient has a torturous or stenosed artery. In the coaxial method, both the anti-coagulated indwelling and coaxial catheters are placed in the artery together, with the coaxial catheter inside the indwelling catheter. The proximal ends of the catheter unit are attached to a connecting pipe, which subsequently connects to the implantable port. Our results show no differences in the cumulative patency rates of the hepatic artery between coaxial and conventional methods of HAIC.
  
  
  CONCLUSIONS
  It is important to continually devise new methods to make HAIC technically less demanding. The coaxial method is free from catheter exchange, and therefore allows easier cannulation of difficult arteries.
authors.affiliation: Department of Gastrointestinal Surgery, Omori Hospital, School of Medicine, Toho University, Tokyo, Japan. masashiwatanabe-gi@umin.ac.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yajima
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Nanami
authors.forename: Yoko
authors.initials: Y
authors.lastname: Oshima
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
authors.forename: Kontoku
authors.initials: K
authors.lastname: Shimokawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002408:Catheters, Indwelling; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000295:instrumentation / Q000379:methods*; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000295:instrumentation*; D053208:Kaplan-Meier Estimate