Yamagami Takuji, Kato Takeharu, Hirota Tatsuya, Yoshimatsu Rika, Matsumoto Tomohiro, White Robert I, Nishimura Tsunehiko
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
Eur Radiol. 2008 Jan;18(1):152-7. doi: 10.1007/s00330-007-0706-y. Epub 2007 Jul 10.
To retrospectively evaluate the use of Micronester coils in port-catheter implantation with the fixed catheter tip method in comparison with other previously used coils. The cohort of this study was 143 consecutive patients with unresectable advanced liver cancer for whom a port-catheter system was percutaneously implanted. In the most recent 32 patients, Micronester coils were used for catheter tip fixation. Details of embolic agents for fixation, persistent blood flow beyond the distal end of the indwelling catheter, and complications were compared between cases without and with Micronester coils. In all, percutaneous port-catheter placement was successful. Mean number of coils used for fixation was 4.2 without Micronester coils vs. 2.5 with Micronester coils. N-butyl cyanoacrylate (NBCA)-Lipiodol was additionally used for catheter tip fixation in 85.6% of 111 procedures without Micronester coils and in 50% of 32 using Micronester coils. The gastroduodenal artery beyond the distal end was not detected at the final examination after any procedure. Catheter dislocation occurred in five and hepatic arterial obstruction or severe stenosis in eight. The number of coils used and necessity of NBCA-Lipiodol could be decreased with usage of Micronester coils without decreasing fixation ability compared to other coils.
回顾性评估与其他先前使用的线圈相比,Micronester线圈在采用固定导管尖端法进行端口导管植入中的应用。本研究队列包括143例连续的不可切除晚期肝癌患者,他们接受了经皮端口导管系统植入。在最近的32例患者中,使用Micronester线圈进行导管尖端固定。比较了使用和未使用Micronester线圈的病例在固定栓塞剂的细节、留置导管远端以外的持续血流以及并发症方面的情况。总体而言,经皮端口导管置入成功。未使用Micronester线圈时固定所用线圈的平均数量为4.2个,而使用Micronester线圈时为2.5个。在111例未使用Micronester线圈的操作中,85.6%额外使用了氰基丙烯酸正丁酯(NBCA)-碘油进行导管尖端固定,在使用Micronester线圈的32例操作中,这一比例为50%。在任何操作后的最终检查中,均未检测到远端以外的胃十二指肠动脉。发生导管移位5例,肝动脉阻塞或严重狭窄8例。与其他线圈相比,使用Micronester线圈可减少所用线圈数量和NBCA-碘油的必要性,同时不降低固定能力。