Evaluation of non-target arterial patency after implantation of hepatic arterial catheter using a modified implantation technique with the fixed catheter tip method

• Published in: Clinical radiology 2009-02, Vol.64 (2), p.164-170
• Main Authors: Yamagami, T, Yoshimatsu, R, Matsumoto, T, Nishimura, T
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Angiography, Digital Subtraction; Antineoplastic Agents - administration & dosage; Biological and medical sciences; Catheters, Indwelling; Contrast Media - pharmacokinetics; Female; Hepatic Artery - diagnostic imaging; Humans; Infusions, Intra-Arterial - methods; Investigative techniques, diagnostic techniques (general aspects); Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Male; Medical sciences; Middle Aged; Radiology; Retrospective Studies; Time Factors; Vascular Patency; Young Adult
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2008.06.016

Aim To retrospectively investigate persistent hepatofugal blood flow in the gastroduodenal artery after implantation of a port-catheter system for repeated hepatic arterial infusion chemotherapy using a modified fixed catheter tip method. Materials and methods A port-catheter system was percutaneously implanted in 150 patients (90 men and 60 women; mean age 64.6 years) with unresectable liver cancer. The persistence of blood flow beyond the end hole of the indwelling catheter via the port obtained immediately and 1–10 days after port-catheter placement was investigated using arteriography. Results In all cases, port-catheter placement was successfully performed. In 64 (42.7%) of the 150 participants, the gastroduodenal artery was detected on arteriography just after implantation. However, arteriography obtained 1–10 days (mean 4.3 days) after implantation revealed the gastroduodenal artery in only two of the 64 participants. In these two patients, persistent blood flow disappeared spontaneously 12 and 15 days after implantation, respectively. Conclusion Closure of the lumen of the distal tip of the catheter beyond the side hole most often occurs spontaneously just after implantation. However, the findings of the present study indicate that closure will occur within 15 days at the latest. This suggests that delaying chemotherapy for about 2 weeks after implantation may be advisable.