Frost Joshua P, Najran Pavan, Bell Jon, Mullan Damian
Radiology and Interventional Radiology, The Christie NHS Foundation Trust, Manchester, GBR.
Cureus. 2021 Oct 18;13(10):e18852. doi: 10.7759/cureus.18852. eCollection 2021 Oct.
Chemosaturation with percutaneous hepatic perfusion (CS-PHP; Hepatic CHEMOSAT® Delivery System, Delcath Systems Inc, Wilmington, Delaware) is an interventional radiology procedure that delivers high doses of melphalan, a chemotherapeutic agent, directly to the liver in patients with unresectable primary and secondary liver tumours. Traditionally, CS-PHP is delivered by arterial access via the femoral artery. However, there can be many risks and adverse effects associated with femoral artery punctures, such as retroperitoneal haemorrhage and haematoma formation. The monitoring and bed rest required following the removal of a femoral arterial catheter may also cause significant distress to patients as they remain immobile, potentially prolonging their stay in hospital. The radial artery is an alternative access point, with fewer reported adverse events and increased patient tolerance when compared with femoral access. This case report details the first reported use of Hepatic CHEMOSAT® therapy being delivered via the radial artery. Two patients received hepatic chemosaturation with no reported complications. This report demonstrates that access via the radial artery is a feasible alternative for the delivery of chemotherapy, which may reduce morbidity and the risks usually associated with femoral access.
经皮肝灌注化疗饱和法（CS-PHP；Hepatic CHEMOSAT®输送系统，Delcath Systems公司，特拉华州威尔明顿）是一种介入放射学程序，可将高剂量化疗药物美法仑直接输送至无法切除的原发性和继发性肝肿瘤患者的肝脏。传统上，CS-PHP通过股动脉进行动脉穿刺给药。然而，股动脉穿刺可能会带来许多风险和不良反应，如腹膜后出血和血肿形成。拔除股动脉导管后所需的监测和卧床休息也可能给患者带来极大痛苦，因为他们需要保持不动，这可能会延长住院时间。桡动脉是另一个穿刺点，与股动脉穿刺相比，其报告的不良事件较少，患者耐受性更高。本病例报告详细介绍了首次报道的通过桡动脉进行Hepatic CHEMOSAT®治疗的情况。两名患者接受了肝化疗饱和治疗，未报告并发症。本报告表明，经桡动脉给药是一种可行的化疗给药替代方法，这可能会降低发病率以及通常与股动脉穿刺相关的风险。
