Yahiro Yoshiyuki, Toyota Naoyuki, Kakizawa Hideaki, Hieda Masashi, Hirai Nobuhiko, Naito Akira, Ito Katsuhide
Department of Radiology, Division of Medical Intelligence and Informatics, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan.
Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):752-5. doi: 10.1007/s00270-005-0291-x.
Our purpose is to evaluate the feasibility and safety of the withdrawal procedure of percutaneous transfemorally implanted port-catheter systems. Thirty-seven patients (17.7%) underwent the withdrawal procedure of this port-catheter system among 209 patients. The reasons for withdrawal were as follows: termination of intra-arterial chemotherapy (n = 7), obstruction of hepatic artery (n = 5), port infection (n = 4), catheter infection (n = 4), catheter obstruction (n = 4), lower-limb palsy and pain (n = 2), exposure of the port due to skin defect (n = 2), patient's desire (n = 2), side effect of chemotherapy (n = 1), no effectiveness of chemotherapy (n = 1), hematoma at the puncture site (n = 1), duodenum perforation by the catheter (n = 1), intermittent claudication due to severe stenosis of right common iliac artery (n = 1), dissection of common hepatic artery (n = 1), and broken catheter (n = 1). In thirty-four of the 37 cases, the port-catheter system was successfully withdrawn without any complications. Clinical success rate was 91.9%. Complications occurred in three cases (8.1%), which were a pseudoaneurysm, thromboembolism of the right common iliac artery, and continuous bleeding from the subcutaneous pocket where the port system was placed for 1 month. In 15 cases, correction of the catheter tip or exchange for dislocation of the tip had to be done without withdrawal. It is not rare to withdraw port-catheter systems in cases of infection or hematoma around the system. Although withdrawal of a percutaneous transfemorally implanted port-catheter system is a relatively safe procedure, the port-catheter system should not be removed unless absolutely indicated.
我们的目的是评估经皮股动脉植入的端口导管系统拔除 procedure 的可行性和安全性。在 209 例患者中,37 例(17.7%)接受了该端口导管系统的拔除 procedure。拔除原因如下:动脉内化疗终止(n = 7)、肝动脉阻塞(n = 5)、端口感染(n = 4)、导管感染(n = 4)、导管阻塞(n = 4)、下肢麻痹和疼痛(n = 2)、由于皮肤缺损导致端口暴露(n = 2)、患者意愿(n = 2)、化疗副作用(n = 1)、化疗无效(n = 1)、穿刺部位血肿(n = 1)、导管导致十二指肠穿孔(n = 1)、右髂总动脉严重狭窄引起间歇性跛行(n = 1)、肝总动脉夹层(n = 1)以及导管断裂(n = 1)。在 37 例中的 34 例中,端口导管系统成功拔除,无任何并发症。临床成功率为 91.9%。3 例(8.1%)出现并发症,分别为假性动脉瘤、右髂总动脉血栓栓塞以及放置端口系统的皮下袋持续出血 1 个月。在 15 例中,不得不对导管尖端进行矫正或更换尖端脱位而不拔除。在系统周围发生感染或血肿的情况下拔除端口导管系统并不罕见。尽管经皮股动脉植入的端口导管系统的拔除是一个相对安全的 procedure,但除非有绝对指征,否则不应拔除端口导管系统。