Annals of Surgical Oncology

, Volume 23, Issue 11, pp 3699–3708 | Cite as

Safety and Feasibility of Repeatable Hepatic Vascular Isolation Chemotherapy: A Pilot Study

  • Rodney J. LaneEmail author
  • Nyan Y. Khin
  • Chris M. Rogan
  • John Magnussen
  • Nick Pavlakis
  • David M. Lane
  • Stephen Clarke
Hepatobiliary Tumors



The authors herein describe a novel method of repeatable hepatic isolation using an implantable access system allowing simultaneous control of hepatic arterial and portal flows by multiple endovascular catheters.


The aim of this study was to assess the feasibility and safety of the system and to compress standard intravenous chemotherapy into 4 weeks of targeted intra-arterial delivery.


An arterial access system was implanted to the axillary artery via an anastomosis. Infusions of oxaliplatin were performed biweekly for 4 weeks, using balloon catheters to achieve hepatic isolation and segmental selectivity for 20–25 min. Fifty-seven treatments under general anesthetic were performed in ten patients with inoperable chemotherapy-refractory metastatic colorectal cancer. Systemic, intrahepatic, and hepatic venous pressures were recorded to assess vascular isolation, and platinum levels were measured to assess chemotherapy distribution.


Pressure verified, multiple day-only hepatic vascular isolation infusions were achieved in nine of ten patients, with a single patient receiving multiple hepatic arterial infusions. Positron emission tomography–computed tomography (PET–CT) imaging confirmed partial response in three of ten patients and stable disease in three of ten patients. Systemic toxicity was minimal as all treatment-related gastrointestinal and neuropathic symptoms reported throughout the 4 weeks were grades 1–2.


Intra-arterial chemotherapy infusions with hepatic vascular isolation can be achieved repeatedly with targeted selectivity and minimal complications using an implantable multicatheter access system. Oxaliplatin infusions over a 4-week period may achieve tumor response in selected patients in the salvage setting. The technique should be further assessed in a phase Ib/II study.


Hepatic Artery Oxaliplatin Tace Rivaroxaban Colorectal Liver Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to acknowledge Cook Medical for advice and catheter supply, Professor Michael Roberts for advice on pharmacokinetics, and Carol Bryant for infrastructure support.


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Rodney J. Lane
    • 1
    • 2
    • 3
    • 4
    Email author
  • Nyan Y. Khin
    • 2
    • 4
  • Chris M. Rogan
    • 1
  • John Magnussen
    • 1
    • 2
  • Nick Pavlakis
    • 3
  • David M. Lane
    • 4
  • Stephen Clarke
    • 3
  1. 1.Macquarie University HospitalSydneyAustralia
  2. 2.Australian School of Advanced MedicineMacquarie UniversitySydneyAustralia
  3. 3.The Royal North Shore HospitalSt Leonards, SydneyAustralia
  4. 4.AllVascular Pty LtdSt Leonards, SydneyAustralia

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