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Percutaneous implantation of arterial Port-a-cath via trans-subclavin access
1Service of Surgical Oncology, University of Turin, Molinette Hospital, Torino, Italy. zanoncl@tin.it
Background:
Hepatic artery infusion is the best choice of treatment for colorectal liver metastases, but it could be suggested for other hepatic tumors or locally advanced pancreatic cancer. The need of a laparotomy for the positioning of the arterial catheter has been the limiting factor for the diffusion of regional treatments.
Materials And Methods:
170 patients suffering from primary or secondary liver tumours and pancreatic or bile ducts cancer, underwent the positioning of intra-arterial hepatic part-a-cath by a transcutaneous subclavian access in local anaesthesia. In 163 patients, a catheter was placed into the hepatic artery, 4 into the splenic and 3 into the gastroduodenal artery.
Results:
The procedure was performed successfully in all patients. We observed 5 aneurysms of the subclavian artery and 9 thrombosis of the hepatic artery. Only in 7 patients was arterial infusion suspended for technical complications. We observed 10.6% of dislocation, but dislodged catheters were always moved again into the hepatic artery.
Conclusions:
The development of percutaneous techniques of arterial port-a-cath implantation could enlarge the indication of regional chemotherapy.