Advertisement

European Radiology

, Volume 18, Issue 1, pp 152–157 | Cite as

Value of Micronester coils in port-catheter implantation for continuous hepatic arterial infusion chemotherapy with fixed catheter tip method

  • Takuji Yamagami
  • Takeharu Kato
  • Tatsuya Hirota
  • Rika Yoshimatsu
  • Tomohiro Matsumoto
  • Robert I. WhiteJr
  • Tsunehiko Nishimura
Interventional

Abstract

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.

Keywords

Arteries Therapeutic blockade Catheters and catheterization Technology Chemotherapeutic infusion Liver Neoplasm Radiology Interventional 

References

  1. 1.
    Lorenz M, Muller HH (2000) Randomized, multicenter trial of fluorouracil plus leucovorin administered either via hepatic arterial or intravenous infusion versus fluorodeoxyuridine administered via hepatic arterial infusion in patients with nonresectable liver metastases from colorectal carcinoma. J Clin Oncol 18:243–254PubMedGoogle Scholar
  2. 2.
    Allen-Mersh TG, Earlam S, Fordy C, Abrams K, Houghton J (1994) Quality of life and survival with continuous hepatic-artery floxuridine infusion for colorectal liver metastasis. Lancet 344:1255–1260PubMedCrossRefGoogle Scholar
  3. 3.
    Valeri A, Mini E, Tonelli P et al (1994) Intra-arterial hepatic chemotherapy with 5-Fluorouracil and 5-Methyltetrahydrofolate in the treatment of unresectable liver metastases from colorectal cancer. Anticancer Res 14:2215–2220PubMedGoogle Scholar
  4. 4.
    Rougier P, Laplanche A, Huguier M et al (1992) Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial. J Clin Oncol 10:1112–1118PubMedGoogle Scholar
  5. 5.
    Niederhuber JE, Ensminger WD (1983) Surgical considerations in the management of hepatic neoplasia. Semin Oncol 10:135–147PubMedGoogle Scholar
  6. 6.
    Huk I, Entscheff P, Prager M, Schulz F, Polterauer P, Funovics J (1990) Patency rate of implantable devices during long-term intraarterial chemotherapy. Angiology 41:936–941PubMedCrossRefGoogle Scholar
  7. 7.
    Tanaka T, Arai Y, Inaba Y et al (2003) Radiologic placement of side-hole catheter with tip fixation for hepatic arterial infusion chemotherapy. J Vasc Interv Radiol 14:63–68PubMedGoogle Scholar
  8. 8.
    Yamagami T, Iida S, Kato T, Tanaka O, Hirota T, Nakamura T, Nishimura T (2002) Using n-butyl cyanoacrylate and the fixed-catheter-tip technique in percutaneous implantation of a port-catheter system in patients undergoing repeated hepatic arterial chemotherapy. AJR 179:1611–1617PubMedGoogle Scholar
  9. 9.
    Wacker FK, Boese-Landgraf J, Wagner A, Albrecht D, Wolf K-J, Fobbe F (1997) Minimally invasive catheter implantation for regional chemotherapy of the liver: a new percutaneous transsubclavian approach. Cardiovasc Intervent Radiol 20:128–132PubMedCrossRefGoogle Scholar
  10. 10.
    Clouse ME, Ahmed R, Ryan RB, Oberfield RA, McCaffrey JA (1977) Complications of long term transbrachial hepatic arterial infusion chemotherapy. AJR 129:799–803PubMedGoogle Scholar
  11. 11.
    Oberfield RA, McCaffrey JA, Polio J, Clouse ME, Hamilton T (1979) Prolonged and continuous percutaneous intra-arterial hepatic infusion chemotherapy in advanced metastatic liver adenocarcinoma from colorectal primary. Cancer 44:414–423PubMedCrossRefGoogle Scholar
  12. 12.
    Herrmann KA, Waggershauser T, Sittek H, Reiser MF (2000) Liver intraarterial chemotherapy: use of the femoral artery for percutaneous implantation of catheter-port systems. Radiology 215:294–299PubMedGoogle Scholar
  13. 13.
    Germer CT, Boese-Landgraf J, Albrecht D, Wagner A, Wolf KJ, Buhr HJ (1996) The totally implantable minimally invasive hepatic arterial catheter for intraarterial chemotherapy of unresectable liver metastasis in cases of dysfunction of arterial access devices. Chirung 67:458–462Google Scholar
  14. 14.
    Strecker E-PK, Boos IBL, Ostheim-Dzerowycz W, Heber R, Vetter SC (1997) Percutaneously implantable catheter-port system: preliminary technical results. Radiology 202:574–577PubMedGoogle Scholar
  15. 15.
    Arai Y, Inaba Y, Takeuchi Y (1997) Interventional techniques for hepatic arterial infusion chemotherapy. In: Castaneda-Zuniga WR (ed) Interventional radiology, 3rd edn. Williams & Wilkins, Baltimore, pp 192–205Google Scholar
  16. 16.
    Yamagami T, Nakamura T, Yamazaki S, Iida S, Kato T, Nishimura T (2002) Catheter-tip fixation of a percutaneously implanted port-catheter system to prevent dislocation. Eur Radiol 12:443–449PubMedCrossRefGoogle Scholar
  17. 17.
    Seki H, Kimura M, Yoshimura N, Yamamoto S, Ozaki T, Sakai K (1999) Hepatic arterial infusion chemotherapy using percutaneous catheter placement with an implantable port: assessment of factors affecting patency of the hepatic artery. Clin Radiol 54:221–227PubMedCrossRefGoogle Scholar
  18. 18.
    Irie T (2001) Intraarterial chemotherapy of liver metastases: implantation of a microcatheter-port system with use of modified catheter tip technique. J Vasc Interv Radiol 12:1215–1218PubMedCrossRefGoogle Scholar
  19. 19.
    Takeuchi Y, Arai Y, Inaba Y et al (1996) A new percutaneous catheterization ‘side-holed catheter placement with fixation’ for a long term arterial chemotherapeutic infusion: Its effectiveness to prevent hepatic arterial occlusion. J Jpn Soc Angiography Interv Radiol 11:471–476Google Scholar
  20. 20.
    Yamagami T, Kato T, Iida S, Hirota T, Nishimura T (2005) Managemant of end hole in placement of port-catheter system for continuous hepatic arterial infusion chemotherapy using the fixed catheter tip method. AJR 184:1332–1339PubMedGoogle Scholar
  21. 21.
    Yamagami T, Kato T, Iida S, Tanaka O, Nishimura T (2004) Value of transcatheter arterial embolization with coils and n-butyl cyanoacrylate for long-term hepatic arterial infusion chemotherapy. Radiology 230:792–802PubMedCrossRefGoogle Scholar
  22. 22.
    Osuga K, White RI Jr (2003) Micronester: a new pushable fibered microcoil for embolotherapy. Cardiovasc Interv Radiol 26:554–556CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Takuji Yamagami
    • 1
  • Takeharu Kato
    • 1
  • Tatsuya Hirota
    • 1
  • Rika Yoshimatsu
    • 1
  • Tomohiro Matsumoto
    • 1
  • Robert I. WhiteJr
    • 2
  • Tsunehiko Nishimura
    • 1
  1. 1.Department of Radiology, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
  2. 2.Department of Diagnostic RadiologyYale University School of MedicineNew HavenUSA

Personalised recommendations