Radiologic removal and replacement of port-catheter systems for hepatic arterial infusion chemotherapy

Toshihiro Iguchi, Yoshitaka Inaba, Yasuaki Arai, Hidekazu Yamaura, Yozo Sato, Masaya Miyazaki, Hiroshi Shimamoto, Takayuki Hayashi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVE. The purpose of our study was to retrospectively evaluate the safety and efficacy of radiologic removal and replacement of port-catheter systems. MATERIALS AND METHODS. Between January 1999 and December 2004, 532 patients with unresectable advanced liver cancer underwent radiologic placement of port-catheter systems at our institution. Of these, 18 patients (nine men and nine women; age range, 32-83 years; mean age, 53.8 years) underwent removal of an implanted port-catheter system via the right femoral artery and radiographically guided replacement with a new system to allow continuous hepatic arterial infusion chemotherapy; we retrospectively reviewed these 18 cases. The reasons for removal of the previously implanted systems were as follows: catheter dislodgement (n = 15), catheter obstruction (n = 1), infection related to the implanted port (n = 1), and hemodynamic change (n = 1). Digital subtraction angiography and CT were performed, usually during injection of contrast medium through the implanted port-catheter system, within a few days after the replacement procedure and every 3 months thereafter. RESULTS. We successfully performed radiologic removal and replacement of the port-catheter system while the patient was under local anesthesia in all 18 patients without complications requiring treatment. The cumulative patency rates of the hepatic artery after removal of the old port-catheter system and replacement with a new port-catheter system were 87.8% and 64.1% at 6 months and 1 year, respectively. Hepatic arterial infusion chemotherapy after replacement was performed 0-68 times (median, 19 times). CONCLUSION. When an implanted port-catheter system can no longer be used but the patency of the hepatic artery is confirmed and continuous hepatic arterial infusion chemotherapy is required, removal and replacement of the port-catheter system are recommended.

Original languageEnglish
Pages (from-to)1579-1584
Number of pages6
JournalAmerican Journal of Roentgenology
Volume187
Issue number6
DOIs
Publication statusPublished - Dec 2006
Externally publishedYes

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Vascular Access Devices
Drug Therapy
Liver
Hepatic Artery
Catheter Obstruction
Digital Subtraction Angiography
Local Anesthesia
Femoral Artery
Liver Neoplasms
Contrast Media
Catheters
Hemodynamics
Safety
Injections

Keywords

  • Chemotherapy
  • Implantable devices
  • Liver cancer
  • Port-catheter system

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Radiologic removal and replacement of port-catheter systems for hepatic arterial infusion chemotherapy. / Iguchi, Toshihiro; Inaba, Yoshitaka; Arai, Yasuaki; Yamaura, Hidekazu; Sato, Yozo; Miyazaki, Masaya; Shimamoto, Hiroshi; Hayashi, Takayuki.

In: American Journal of Roentgenology, Vol. 187, No. 6, 12.2006, p. 1579-1584.

Research output: Contribution to journalArticle

Iguchi, T, Inaba, Y, Arai, Y, Yamaura, H, Sato, Y, Miyazaki, M, Shimamoto, H & Hayashi, T 2006, 'Radiologic removal and replacement of port-catheter systems for hepatic arterial infusion chemotherapy', American Journal of Roentgenology, vol. 187, no. 6, pp. 1579-1584. https://doi.org/10.2214/AJR.05.0646
Iguchi, Toshihiro ; Inaba, Yoshitaka ; Arai, Yasuaki ; Yamaura, Hidekazu ; Sato, Yozo ; Miyazaki, Masaya ; Shimamoto, Hiroshi ; Hayashi, Takayuki. / Radiologic removal and replacement of port-catheter systems for hepatic arterial infusion chemotherapy. In: American Journal of Roentgenology. 2006 ; Vol. 187, No. 6. pp. 1579-1584.
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abstract = "OBJECTIVE. The purpose of our study was to retrospectively evaluate the safety and efficacy of radiologic removal and replacement of port-catheter systems. MATERIALS AND METHODS. Between January 1999 and December 2004, 532 patients with unresectable advanced liver cancer underwent radiologic placement of port-catheter systems at our institution. Of these, 18 patients (nine men and nine women; age range, 32-83 years; mean age, 53.8 years) underwent removal of an implanted port-catheter system via the right femoral artery and radiographically guided replacement with a new system to allow continuous hepatic arterial infusion chemotherapy; we retrospectively reviewed these 18 cases. The reasons for removal of the previously implanted systems were as follows: catheter dislodgement (n = 15), catheter obstruction (n = 1), infection related to the implanted port (n = 1), and hemodynamic change (n = 1). Digital subtraction angiography and CT were performed, usually during injection of contrast medium through the implanted port-catheter system, within a few days after the replacement procedure and every 3 months thereafter. RESULTS. We successfully performed radiologic removal and replacement of the port-catheter system while the patient was under local anesthesia in all 18 patients without complications requiring treatment. The cumulative patency rates of the hepatic artery after removal of the old port-catheter system and replacement with a new port-catheter system were 87.8{\%} and 64.1{\%} at 6 months and 1 year, respectively. Hepatic arterial infusion chemotherapy after replacement was performed 0-68 times (median, 19 times). CONCLUSION. When an implanted port-catheter system can no longer be used but the patency of the hepatic artery is confirmed and continuous hepatic arterial infusion chemotherapy is required, removal and replacement of the port-catheter system are recommended.",
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AU - Iguchi, Toshihiro

AU - Inaba, Yoshitaka

AU - Arai, Yasuaki

AU - Yamaura, Hidekazu

AU - Sato, Yozo

AU - Miyazaki, Masaya

AU - Shimamoto, Hiroshi

AU - Hayashi, Takayuki

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N2 - OBJECTIVE. The purpose of our study was to retrospectively evaluate the safety and efficacy of radiologic removal and replacement of port-catheter systems. MATERIALS AND METHODS. Between January 1999 and December 2004, 532 patients with unresectable advanced liver cancer underwent radiologic placement of port-catheter systems at our institution. Of these, 18 patients (nine men and nine women; age range, 32-83 years; mean age, 53.8 years) underwent removal of an implanted port-catheter system via the right femoral artery and radiographically guided replacement with a new system to allow continuous hepatic arterial infusion chemotherapy; we retrospectively reviewed these 18 cases. The reasons for removal of the previously implanted systems were as follows: catheter dislodgement (n = 15), catheter obstruction (n = 1), infection related to the implanted port (n = 1), and hemodynamic change (n = 1). Digital subtraction angiography and CT were performed, usually during injection of contrast medium through the implanted port-catheter system, within a few days after the replacement procedure and every 3 months thereafter. RESULTS. We successfully performed radiologic removal and replacement of the port-catheter system while the patient was under local anesthesia in all 18 patients without complications requiring treatment. The cumulative patency rates of the hepatic artery after removal of the old port-catheter system and replacement with a new port-catheter system were 87.8% and 64.1% at 6 months and 1 year, respectively. Hepatic arterial infusion chemotherapy after replacement was performed 0-68 times (median, 19 times). CONCLUSION. When an implanted port-catheter system can no longer be used but the patency of the hepatic artery is confirmed and continuous hepatic arterial infusion chemotherapy is required, removal and replacement of the port-catheter system are recommended.

AB - OBJECTIVE. The purpose of our study was to retrospectively evaluate the safety and efficacy of radiologic removal and replacement of port-catheter systems. MATERIALS AND METHODS. Between January 1999 and December 2004, 532 patients with unresectable advanced liver cancer underwent radiologic placement of port-catheter systems at our institution. Of these, 18 patients (nine men and nine women; age range, 32-83 years; mean age, 53.8 years) underwent removal of an implanted port-catheter system via the right femoral artery and radiographically guided replacement with a new system to allow continuous hepatic arterial infusion chemotherapy; we retrospectively reviewed these 18 cases. The reasons for removal of the previously implanted systems were as follows: catheter dislodgement (n = 15), catheter obstruction (n = 1), infection related to the implanted port (n = 1), and hemodynamic change (n = 1). Digital subtraction angiography and CT were performed, usually during injection of contrast medium through the implanted port-catheter system, within a few days after the replacement procedure and every 3 months thereafter. RESULTS. We successfully performed radiologic removal and replacement of the port-catheter system while the patient was under local anesthesia in all 18 patients without complications requiring treatment. The cumulative patency rates of the hepatic artery after removal of the old port-catheter system and replacement with a new port-catheter system were 87.8% and 64.1% at 6 months and 1 year, respectively. Hepatic arterial infusion chemotherapy after replacement was performed 0-68 times (median, 19 times). CONCLUSION. When an implanted port-catheter system can no longer be used but the patency of the hepatic artery is confirmed and continuous hepatic arterial infusion chemotherapy is required, removal and replacement of the port-catheter system are recommended.

KW - Chemotherapy

KW - Implantable devices

KW - Liver cancer

KW - Port-catheter system

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