Hayashi N, Sakai T, Kitagawa M, Kimoto T, Ishii Y
Department of Radiology, Fukui Medical School, Japan.
Eur J Radiol. 1998 Feb;26(3):304-8. doi: 10.1016/s0720-048x(97)01162-5.
To clarify the clinical feasibility of getting a long-term arterial access at the subclavian region by directly puncturing the artery under ultrasound guidance.
Percutaneous placements of arterial infusion catheters with implantable ports were performed in 30 patients with malignant abdominal tumors. The axillary artery in the subclavian region was punctured directly with an 18G needle under ultrasound guidance. Using the Seldinger technique, a 5Fr catheter was placed with its tip in the hepatic or the other tumor-supplying arteries. The catheter was connected to an implantable port, and both of them were embedded in the subcutaneous pocket.
Percutaneous placements of infusion catheters were successfully performed in 29 cases. Transarterial chemotherapy through implanted ports was done uneventfully in 26 patients, while in the other three cases, catheter dislodgment occurred. Two local haematomas, one wound infection and one cerebellar infarction were also experienced.
Ultrasound-guided subclavian approach is a minimally invasive way of implanting an infusion catheter for chemotherapy, although its indication for severely atherosclerotic patients should be limited.
阐明在超声引导下直接穿刺锁骨下区域动脉建立长期动脉通路的临床可行性。
对30例腹部恶性肿瘤患者行经皮穿刺植入带植入式端口的动脉输注导管。在超声引导下用18G穿刺针直接穿刺锁骨下区域的腋动脉。采用Seldinger技术，将一根5Fr导管尖端置于肝动脉或其他肿瘤供血动脉内。将导管与植入式端口相连，并将两者埋入皮下囊袋。
29例成功完成经皮输注导管植入。26例患者通过植入端口顺利进行了经动脉化疗，另外3例发生导管移位。还出现了2例局部血肿、1例伤口感染和1例小脑梗死。
超声引导下锁骨下动脉入路是一种微创植入化疗输注导管的方法，但其在严重动脉粥样硬化患者中的应用应受到限制。
