Grosso M, Scarrone A, Pedrazzini F, Priotto R, Testa F, Lingua G, Mondino I, Zanon C
Department of Radiology, Santa Croce Hospital, Cuneo, Italy.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):171-5.
In the past, intrahepatic arterial locoregional chemotherapy was performed by surgical approach via gastroduodenal artery; early use of percutaneously placed arterial port was complicated by clotting and bleeding in 50% of pts. More recently, permanent catheters were positioned percutaneously in GDA by Japanese group and fixed to the artery by means of bucrylate in order to reduce dislocation. We present the technique and the preliminary results of percutaneous implantation of intraarterial catheters connected to a subcutaneous infusion reservoir for prolonged regional chemotherapy of hepatic tumors. Two hundred patients underwent to percutaneous arterial port implant, for loco-regional chemotherapy for liver primary or metastatic tumors. Catheter dislodgments were observed in 14,5%, but in 90% the catheters could be reinserted. No case of catheter related mortality was registered. Percutaneous positioning of arterial port is a safe and effective technique to deliver loco-regional treatment for hepatic tumors. Complication rates are similar to the surgical series and to other percutaneous interventional radiological reports. This percutaneous approach in the hands of a skilled team allows intra-arterial infusion in a wide percentage of pts, improving the accuracy of clinical trials by a faster and optimal balanced comparison between systemic and arterial arm.
过去，肝内动脉局部化疗通过经胃十二指肠动脉的手术方法进行；早期经皮放置动脉端口，50%的患者出现凝血和出血并发症。最近，日本团队经皮将永久性导管置于胃十二指肠动脉，并通过氰基丙烯酸酯固定于动脉以减少移位。我们介绍经皮植入与皮下输注储器相连的动脉内导管用于肝肿瘤延长区域化疗的技术及初步结果。200例患者接受经皮动脉端口植入，用于肝脏原发性或转移性肿瘤的局部区域化疗。观察到14.5%的导管发生移位，但90%的导管可重新插入。未记录到与导管相关的死亡病例。经皮放置动脉端口是一种安全有效的技术，可用于肝肿瘤的局部区域治疗。并发症发生率与手术系列及其他经皮介入放射学报告相似。由技术熟练的团队操作这种经皮方法，可使很大比例的患者进行动脉内输注，通过在全身和动脉途径之间更快且最佳平衡的比较提高临床试验的准确性。
