title: Hepatic arterial infusion chemotherapy by the fixed-catheter-tip method: retrospective comparison of percutaneous left subclavian and femoral port-catheter system implantation.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively compare the subclavian and femoral approaches to a fixed-catheter-tip method of implantation of a port-catheter system for hepatic arterial infusion chemotherapy with respect to complications and dysfunctions.
  
  
  METHODS
  Between April 2006 and April 2012, 153 patients (104 men, 49 women; age range, 23-82 years; mean, 65 years) with unresectable malignant liver tumors underwent percutaneous implantation of indwelling port-catheter systems by the fixed-catheter-tip method via the left subclavian or femoral artery. The success of implantation and outcome of complications were investigated and compared between these approach routes.
  
  
  RESULTS
  The overall technical success rate of port-catheter system implantation with the fixed-catheter-tip method was 99% (152 of 153 patients). Seventy-five patients underwent implantation with a port-catheter system via the left subclavian artery, and 77 patients via the femoral artery. Catheter dislocation occurred in 3.9% of the patients; hepatic artery obstruction, 2.6%; catheter occlusion, 3.9%; bleeding at the puncture site, 3.9%; cerebral infarction, 1.3%; and infection related to port-catheter implantation, 2.6%. No significant differences in complications and port-catheter system dysfunction between the left subclavian and femoral approaches to port-catheter system implantation with the fixed-catheter-tip method were seen in any of the parameters. In addition, cerebral infarction occurred exclusively with the left subclavian approach, whereas infection occurred exclusively with the femoral approach.
  
  
  CONCLUSIONS
  Implantation of the port-catheter system with the fixed-catheter-tip method is equally feasible via both the left subclavian and the femoral approaches.
authors.affiliation: 1 Department of Diagnostic Radiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.forename: Rika
authors.initials: R
authors.lastname: Yoshimatsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morishita
authors.forename: Noriko
authors.initials: N
authors.lastname: Kitamura
authors.forename: Osamu
authors.initials: O
authors.lastname: Sato
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Hasebe
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002408:Catheters, Indwelling; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011183:Postoperative Complications; D011677:Punctures; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents