Kuroiwa T, Honda H, Yoshimitsu K, Irie H, Aibe H, Tajima T, Shinozaki K, Masuda K
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Cardiovasc Intervent Radiol. 2001 Mar-Apr;24(2):90-3. doi: 10.1007/s002700000376.
A port-catheter system was implanted via femoral artery access for hepatic artery chemotherapy infusion. Implantation was attempted in 90 patients and was successful in 88. Blood flow redistribution was performed using embolization coils. In the first ten patients a soft heparin-coated infusion catheter was used. For the following 78 patients we used a stiffer catheter coated with fluorine-acryl-styrene-urethane-silicone (FASUS) copolymer. The catheter was connected to a port implanted subcutaneously below the level of the inguinal ligament. Complications during the procedure and after placement were observed in 7 of 90 patients and 24 of 88 patients, respectively. These included catheter obstruction (11%), dislocation of the catheter tip (10%), drug toxicity (5.7%), and catheter infection (3.4%). In 6 of 10 patients with catheter obstruction, recanalization of the port system was achieved. In 7 of 9 patients with dislocation of the indwelling catheter tip, replacement of the port system was successful. Our complications appear to be comparable with those encountered with the subclavian/brachial approach when the new catheter coating is used. Notable is the avoidance of cerebral infarcts.
通过股动脉穿刺植入了一个导管系统用于肝动脉化疗灌注。90例患者尝试进行植入，88例成功。使用栓塞线圈进行血流再分布。最初的10例患者使用了柔软的肝素涂层灌注导管。对于随后的78例患者，我们使用了涂有氟丙烯酸苯乙烯聚氨酯硅氧烷（FASUS）共聚物的更硬导管。导管连接到植入腹股沟韧带水平以下皮下的端口。手术过程中和放置后分别在90例患者中的7例和88例患者中的24例观察到并发症。这些包括导管阻塞（11%）、导管尖端移位（10%）、药物毒性（5.7%）和导管感染（3.4%）。在10例导管阻塞患者中的6例，实现了端口系统的再通。在9例留置导管尖端移位患者中的7例，端口系统更换成功。当使用新的导管涂层时，我们的并发症似乎与锁骨下/肱动脉途径所遇到的并发症相当。值得注意的是避免了脑梗死。
