Yamagami Takuji, Iida Shigeharu, Kato Takeharu, Tanaka Osamu, Hirota Tatsuya, Nakamura Toshiyuki, Nishimura Tsunehiko
Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-0841, Japan.
AJR Am J Roentgenol. 2002 Dec;179(6):1611-7. doi: 10.2214/ajr.179.6.1791611.
The purpose of our study was to evaluate the usefulness of adding n-butyl cyanoacrylate to microcoils to fix the catheter tip in percutaneous implantation of a port-catheter system for hepatic arterial-infusion chemotherapy.
Ninety-three patients (64 men and 29 women; age range, 38-83 years; mean age, 62.2 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system with the catheter tip fixed at the gastroduodenal artery with microcoils and a mixture of n-butyl cyanoacrylate and iodized oil. The rates of successful implantation and complications closely associated with this technique and management of the complications were reviewed.
Percutaneous port-catheter placement was successfully performed in all patients. However, in eight patients, complications occurred: hepatic arterial obstruction (n = 5, 5.4%); catheter dislocation (n = 2, 2.2%); recanalization of the gastroduodenal artery (n = 1, 1.1%); or movement of n-butyl cyanoacrylate (n = 1, 1.1%). In five of the eight patients with complications, hepatic arterial-infusion chemotherapy was continued either after observation of the patient to ensure that stability had been established or after treatment using comparatively easy interventional techniques. In three (3.2%) of the 93 patients, planned hepatic arterial-infusion chemotherapy could not be performed because of complications associated with the technique.
Fixation of the catheter tip in the gastroduodenal artery using a combination of microcoils and a mixture of n-butyl cyanoacrylate and iodized oil is a useful and safe technique in percutaneous port-catheter placement for repeated hepatic arterial infusion chemotherapy.
本研究旨在评估在经皮植入用于肝动脉灌注化疗的植入式给药装置时，将氰基丙烯酸正丁酯添加到微线圈中以固定导管尖端的有效性。
93例无法切除的晚期肝癌患者（64例男性，29例女性；年龄范围38 - 83岁；平均年龄62.2岁）接受了经皮植入植入式给药装置，导管尖端通过微线圈以及氰基丙烯酸正丁酯与碘化油的混合物固定于胃十二指肠动脉。回顾了成功植入率、与该技术密切相关的并发症以及并发症的处理情况。
所有患者均成功完成经皮植入植入式给药装置。然而，8例患者出现了并发症：肝动脉阻塞（5例，5.4%）；导管移位（2例，2.2%）；胃十二指肠动脉再通（1例，1.1%）；或氰基丙烯酸正丁酯移位（1例，1.1%）。在8例有并发症的患者中，5例在观察患者确保病情稳定后或采用相对简单的介入技术治疗后继续进行肝动脉灌注化疗。93例患者中有3例（3.2%）因与该技术相关的并发症而无法进行计划中的肝动脉灌注化疗。
在经皮植入用于重复肝动脉灌注化疗的植入式给药装置时，使用微线圈以及氰基丙烯酸正丁酯与碘化油的混合物将导管尖端固定于胃十二指肠动脉是一种有用且安全的技术。
