Abstract
Purpose
Development of a percutaneously implantable catheter system for regional chemotherapy of liver metastases and its application in patients with surgically implanted but dislocated catheters.
Methods
Thirty-three patients with liver metastases of colorectal tumors were submitted to percutaneous puncture of the subclavian artery and insertion of a catheter whose tip was placed in the proper hepatic artery and whose end was subcutaneously connected with an infusion pump.
Results
The mean duration of therapy via the percutaneously inserted catheter was 27 weeks (±14 weeks). The most frequent complication was disconnection of the therapy catheter from the tube of the infusion pump. Eighty percent of all complications were corrected by reintervention. The therapy drop-out rate due to catheter-associated complications was 9%.
Conclusion
Percutaneous insertion of a catheter for regional chemotherapy of the liver is a relatively uncomplicated method with high patient acceptance and simple access for reintervention.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Boese-Landgraf J, Häring R, Berger G, Weber B, Hopfenmüller W, Hager K (1993) Gibt es prognostische Parameter, die den Erfolg einer regionalen Chemotherapie bei nichtresektablen Lebermetastasen kolorektaler Karzinome vorhersagen? Zentralbl Chir 118:273–278
Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J (1994) Factors influencing the natural history of colorectal liver metastases. Lancet 343:1405–1410
Breedis C, Young G (1954) The blood supply of neoplasms in the liver. Am J Pathol 30:969–985
Niederhuber JE, Ensminger W, Gyves J, Thrall J, Walker S, Cozzi E (1984) Regional chemotherapy of colorectal cancer metastatic to liver. Cancer 53:1336–1343
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 344:1255–1260
Arai Y, Endo T, Sone Y, Tohyama N, Inaba Y, Kohno S, Ariyoshi Y, Kido C (1992) Management of patients with unresectable liver metastases from colorectal and gastric cancer employing an implantable port system. Cancer Chemother Pharmacol 31:S99-S102
Charnsangavej C, Kirk IR, Dubrow RA, Chuang VP, Curley SA, Roh MS, Varma DGK, Patt YZ (1993) Arterial complications from long-term hepatic artery chemoinfusion catheters: Evaluation with CT. AJR 160:859–864
Hottentrott C, Lorenz M, Baum RP, Kirkowa-Reimann M, Herrhausen T, Inglis R (1990) Six years of experience with local chemotherapy of the liver. In: Jakesz R, Rainer H (eds) Progress in Regional Cancer Therapy. Springer, Berlin Heidelberg New York, pp 52–63
Hohn DC, Stagg RJ, Friedman MA, Hannigan JF, Rayner A, Ignoffo RJ, Acord P, Lewis BJ (1989) A randomized trial of continuous intravenous versus hepatic intraarterial floxuridine in patients with colorectal cancer metastatic to the liver: The Northern California Oncology Group trial. J Clin Oncol 7:1646–1654
Fobbe F, Wacker F, Boese-Landgraf J, Wolf KJ (1995) Transsubclavian percutaneous implantation of a therapy-catheter-device for loco-regional chemotherapy of the liver. (abstract) Eur Radiol 5:S186
Kemeny N (1992) Review of regional therapy of liver metastases in colorectal cancer. Semin Oncol 19:155–162
Curley SA, Roh MS, Chase JL, Hohn DC (1993) Adjuvant hepatic arterial infusion chemotherapy after curative resection of colorectal liver metastases. Am J Surg 166:743–748
Rougier P, Laplanche A, Huguier M, Hay JM, Ollivier JM, Escat J, Salmon R, Julien M, Roullet Audy JC, Gallot D, et al. (1992) Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: Long term result of a prospective randomized trial. J Clin Oncol 10:1112–1118
Pentecost MJ (1993) Transcatheter treatment of hepatic metastases. AJR 160:1171–1175
Reed ML, Vaitkevicius VK, Al-Sarraf M, Vaughn CB, Singhakowinta A, Sexon-Porte M, Izbicki R, Baker L, Straatsma GW (1981) The practicality of chronic hepatic artery infusion therapy of primary and metastatic hepatic malignancies. Cancer 47:402–409
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 44:414–423
Forsberg L, Hafstrom L, Lunderquist A, Sundqvist K (1978) Arterial changes during treatment with intrahepatic arterial infusion of 5-fluorouracil. Radiology 126:49–52
Yoshikawa M, Ebara M, Nakano T, Minoyama A, Sugiura N, Ohto M (1992) Percutaneous transaxillary catheter insertion for hepatic artery infusion chemotherapy. AJR 158:885–886
Oi H, Kishimoto H, Matsushita M, Hori M, Nakamura H (1996) Percutaneous implantation of hepatic artery infusion reservoir by sonographically guided left subclavian artery puncture. AJR 166:821–822
Bledin AG, Kim EE, Chuang VP, Wallace S, Haynie TP (1984) Changes of arterial blood flow patterns during infusion chemotherapy as monitored by intraarterially injected technetium-99m macroaggregated albumin. Br J Radiol 57:197–203
Roth J, Wallner B, Safi F (1989) Arterial perfusion abnormalities of the liver after hepatic arterial infusion chemotherapy and their correlation with changes in the metastases: Evaluation with CT and angiography. AJR 153:751–754
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wacker, F.K., Boese-Landgraf, J., Wagner, A. et al. Minimally invasive catheter implantation for regional chemotherapy of the liver: A new percutaneous transsubclavian approach. Cardiovasc Intervent Radiol 20, 128–132 (1997). https://doi.org/10.1007/s002709900120
Issue Date:
DOI: https://doi.org/10.1007/s002709900120