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[A study of complications of hepatic arterial infusion catheter]
Insights
A new technique using the Anthron P-U catheter for hepatic artery infusion reduced complications in liver cancer patients. This method, involving gastroduodenal artery cannulation, showed fewer catheter issues compared to standard methods.
Area of Science:
- Oncology
- Vascular Surgery
- Medical Devices
Context:
- Hepatocellular carcinoma and metastatic liver tumors require effective intra-arterial therapies.
- Implantable infusion ports connected to hepatic artery catheters are used for chemotherapy delivery.
- Catheter-related complications can significantly impact treatment efficacy and patient outcomes.
Purpose:
- To compare the complication rates of two different infusion catheters (Infuse-A-Port vs. Anthron P-U) used for hepatic artery implantation.
- To evaluate the effectiveness of a modified cannulation technique via the gastroduodenal artery in reducing catheter-related complications.
Summary:
- A study involving 43 patients (32 with hepatocellular carcinoma, 11 with metastatic liver tumors) assessed complications from hepatic artery infusion catheters.
- The Infuse-A-Port catheter (A group, n=31) showed a 54.8% complication rate, including catheter tip dislocation, arterial occlusion, and port occlusion.
- The Anthron P-U catheter with a modified gastroduodenal artery cannulation technique (B group, n=12) demonstrated a lower complication rate of 25.0%, with improved catheter longevity.
Impact:
- The modified cannulation technique using the Anthron P-U catheter may decrease the incidence of serious complications associated with hepatic artery infusion therapy.
- This approach has the potential to improve treatment delivery and patient safety in managing liver malignancies.
Abstract:
We studied complications of the infusion catheter, which were implanted in the hepatic artery under laparotomy, and then connected with an implantable infuser port in patients with hepatocellular carcinoma (n = 32) and metastatic liver tumor (n = 11). Infuse-A-Port catheter was used for 31 cases (A group), and Anthron P-U catheter for 12 cases (B group). In B group, the cannulation method was changed; the catheter was placed in the hepatic artery via the gastroduodenal artery, which was ligated and cut to prevent kinks in the catheter. In the A group, 17 cases (54.8%) showed complications such as dislocation of the catheter tip (7 cases) including penetrating duodenal ulcer (2 cases), arterial occlusion (6 cases), injury of catheter (2 cases) and occlusion of the infuser port (2 cases). One case, however, having a fistula between the hepatic artery and the duodenum, died of sudden massive bleeding. In the B group, 3 cases (25.0%) showed complications such as dislocation of the catheter tip (1 case) and arterial occlusion (2 cases). The catheter in B group lasted longer than that in A group. Thus, our cannulation technique using Anthron P-U catheter may decrease the catheter complications.