title: Chronic intrapericardial catheterization for repeated drug delivery: technical feasibility study in the Göttingen minipig.
abstract: BACKGROUND
  A minimally invasive pericardial access and chronic catheterization may enhance the therapeutic effects of intrapericardial drug delivery. We aimed to evaluate the technical feasibility of percutaneous intrapericardial implantation of a drug port system for chronic local drug delivery.
  
  
  RESULTS
  Under fluoroscopic guidance, a percutaneous subxiphoid access to the pericardial space was obtained with fine needle and micropuncture set in 6 Göttingen minipigs. A 6.4 Fr silicone tube and its drug port were implanted into the pericardial space and a subcutaneous pocket. One animal was euthanized immediately after procedure for acute macroscopic study. The other 5 animals were followed monthly for 2 months and then euthanized for chronic macroscopic study. Technical success was obtained in all animals. The mean procedure duration was 55.3 ± 9.6 minutes and the mean radiation exposure time was 7.9 ± 1.9 minutes. Acute macroscopic study showed no pericardial laceration at the entry site and no gross injury to the nearby epicardium. Follow-ups demonstrated that the pericardial space was intact and silicone catheters kept patent in all cases. No migration of the catheter tip out of the pericardial space or leakage of contrast was observed. All the catheters were easily removed at the end of study. Infection of the subcutaneous tunnel as a major complication was found in 1 pig. Small scattered adhesions of the pericardial space were observed in 2 pigs at chronic macroscopic study.
  
  
  CONCLUSIONS
  Percutaneous intrapericardial catheterization for chronic local drug delivery is technically feasible and of potential for clinical trial.
authors.affiliation: Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain. feisun@ccmijesususon.com
authors.forename: Fei
authors.initials: F
authors.lastname: Sun
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Sánchez
authors.forename: Javier
authors.initials: J
authors.lastname: Fernández-Portales
authors.forename: Verónica
authors.initials: V
authors.lastname: Crisóstomo
authors.forename: Idoia
authors.initials: I
authors.lastname: Díaz-Güemes
authors.forename: Claudia
authors.initials: C
authors.lastname: Báez-Díaz
authors.forename: Jesús
authors.initials: J
authors.lastname: Usón
authors.forename: Manuel
authors.initials: M
authors.lastname: Maynar
mesh_terms: D000818:Animals; D002408:Catheters, Indwelling; D005240:Feasibility Studies; D015918:Infusion Pumps, Implantable; D010496:Pericardium; D013552:Swine; D013556:Swine, Miniature