Yamagami T, Yoshimatsu R, Matsumoto T, Nishimura T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan.
Clin Radiol. 2009 Feb;64(2):164-70. doi: 10.1016/j.crad.2008.06.016. Epub 2008 Nov 13.
To retrospectively investigate persistent hepatofugal blood flow in the gastroduodenal artery after implantation of a port-catheter system for repeated hepatic arterial infusion chemotherapy using a modified fixed catheter tip method.
A port-catheter system was percutaneously implanted in 150 patients (90 men and 60 women; mean age 64.6 years) with unresectable liver cancer. The persistence of blood flow beyond the end hole of the indwelling catheter via the port obtained immediately and 1-10 days after port-catheter placement was investigated using arteriography.
In all cases, port-catheter placement was successfully performed. In 64 (42.7%) of the 150 participants, the gastroduodenal artery was detected on arteriography just after implantation. However, arteriography obtained 1-10 days (mean 4.3 days) after implantation revealed the gastroduodenal artery in only two of the 64 participants. In these two patients, persistent blood flow disappeared spontaneously 12 and 15 days after implantation, respectively.
Closure of the lumen of the distal tip of the catheter beyond the side hole most often occurs spontaneously just after implantation. However, the findings of the present study indicate that closure will occur within 15 days at the latest. This suggests that delaying chemotherapy for about 2 weeks after implantation may be advisable.
采用改良的固定导管尖端法,回顾性研究经皮肝动脉穿刺置管系统植入后胃十二指肠动脉持续存在的肝外血流情况,用于重复肝动脉灌注化疗。
对150例无法切除的肝癌患者(90例男性,60例女性;平均年龄64.6岁)经皮植入经皮肝动脉穿刺置管系统。在置管后即刻及1 - 10天,通过动脉造影研究经端口留置导管末端孔外血流的持续性。
所有病例均成功完成经皮肝动脉穿刺置管系统植入。在150名参与者中,64例(42.7%)在植入后动脉造影时检测到胃十二指肠动脉。然而,植入后1 - 10天(平均4.3天)的动脉造影显示,64例参与者中只有2例检测到胃十二指肠动脉。在这两名患者中,持续血流分别在植入后12天和15天自行消失。
导管侧孔远端尖端管腔的闭合最常发生在植入后即刻,但本研究结果表明,闭合最迟将在15天内发生。这表明植入后延迟约2周进行化疗可能是可取的。