Yamagami T, Kato T, Nishimura T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto 602-8566, Japan.
Australas Radiol. 2005 Dec;49(6):508-11. doi: 10.1111/j.1440-1673.2005.01482.x.
The authors report a case in which catheter-related difficulties occurred with a port-catheter system implanted to perform repeated hepatic arterial infusion chemotherapy for advanced hepatocellular carcinomas. The port-catheter system had been percutaneously implanted with the catheter tip fixation method, and a side hole had been created in the indwelling catheter for placement in the common hepatic artery. Four months after port-catheter placement, however, the indwelling catheter became bent at the location of the side hole in the proper hepatic artery. Subsequently, the side hole moved into the left hepatic artery, resulting in a lack of distribution of chemotherapeutic agents to the tumours in the segments of the liver supplied by the right hepatic artery. This situation was easily corrected with a simple interventional radiological method so that hepatic arterial infusion chemotherapy could be resumed with sufficient distribution over the entire liver. To our knowledge, such a problem involving a port-catheter system implanted with the catheter tip fixation method and its management thereafter has not been reported in the published literature.
作者报告了一例病例,该病例中,为晚期肝细胞癌进行重复肝动脉灌注化疗而植入的输液港-导管系统出现了与导管相关的问题。输液港-导管系统采用经皮穿刺植入导管尖端固定法,在留置导管上开了一个侧孔,以便放置在肝总动脉中。然而,在放置输液港-导管四个月后,留置导管在肝右动脉侧孔处发生弯曲。随后,侧孔移至肝左动脉,导致化疗药物无法分布到由肝右动脉供血的肝段肿瘤中。通过一种简单的介入放射学方法很容易纠正了这种情况,从而可以恢复肝动脉灌注化疗,并使药物在整个肝脏充分分布。据我们所知,已发表的文献中尚未报道过采用导管尖端固定法植入的输液港-导管系统出现此类问题及其后续处理情况。