Efficacy and safety of hepatic artery infusion catheter placement without fixation in the right gastroepiploic artery.

PURPOSE

To evaluate the feasibility of placing the tip of an infusion catheter in the right gastroepiploic artery via the femoral route and whether coil placement in the gastroduodenal artery and around the infusion catheter tip should be performed to avoid gastroduodenal toxicity and catheter dislocation.

MATERIALS AND METHODS

Seventy-eight patients (25 women and 53 men; age, 38-79 years; mean, 63 years) underwent implantation of a 5-F chemotherapeutic infusion catheter via the femoral artery, positioned so that the tip was in the right gastroepiploic artery and a side hole was in the common hepatic artery. Patients were randomly divided into two groups: group A included patients with coil placement in the gastroduodenal artery and around the infusion catheter tip and group B included patients without coil placement.

RESULTS

Catheter placement via the femoral route was successful in 70 of 78 patients (90%). Mean catheter indwell durations were 250 days (range, 0-962 days) in group A (n = 35) and 230 days (range, 0-834 days) in group B (n = 43; P = .9). Complications relating to long-term catheter duration in the right gastroepiploic artery did not occur in any patient. Two patients in each group had abdominal pain during infusion chemotherapy. Endoscopy revealed acute gastric mucosal lesions. Dislocation of the catheter tip during treatment occurred in one patient in each group.

CONCLUSION

Catheter placement in the right gastroepiploic artery is safe and feasible except in patients with a long and caudally oriented celiac trunk. Coil embolization of the gastroduodenal artery and around the catheter tip is unnecessary.