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Infectious complications of hepatic artery catheterization procedures in patients with cancer
E Wong1, N Khardori, C H Carrasco
1Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston.
Insights
Hepatic artery catheterization procedures for cancer treatment resulted in a 3.4% infection rate. Infectious complications, including cholangitis and liver abscesses, were successfully treated with antibiotics and drainage.
Area of Science:
- Interventional Radiology
- Oncology
- Infectious Diseases
Background:
- Hepatic artery catheterization is a key treatment for various cancers.
- Understanding infection risks associated with these procedures is crucial for patient safety.
Purpose of the Study:
- To evaluate the incidence and types of infectious complications following hepatic artery catheterization procedures.
- To analyze infection rates across different chemoinfusion and embolization techniques.
Main Methods:
- Retrospective analysis of 353 hepatic artery catheterization procedures in 211 cancer patients from January to December 1988.
- Categorization of procedures into embolization, chemoembolization, and chemoinfusion.
- Documentation and analysis of all infectious complications, including causative organisms and treatment outcomes.
Main Results:
- An overall infection rate of 3.4% was observed.
- Infectious complication rates varied: 3.1% for embolization, 1.9% for chemoinfusion, and 4.1% for combined embolization and chemoinfusion.
- Four patients experienced severe infections (cholangitis, liver abscess, septicemia), predominantly caused by enteric gram-negative bacilli. No prophylactic antibiotics were used.
Conclusions:
- Hepatic artery catheterization procedures carry a low but significant risk of infectious complications.
- Prompt antimicrobial therapy and percutaneous drainage are effective in managing these infections.
- Further research into prophylactic strategies may be warranted.
Abstract:
A total of 353 hepatic artery catheterization procedures were carried out in 211 patients with cancer over a 1-year period (January-December 1988). The procedures included 49 embolizations in 32 patients, 123 chemoembolizations in 73 patients, and 181 chemoinfusions in 106 patients. The overall infection rate was 3.4%. Infectious complications occurred in 3.1% of patients undergoing hepatic artery embolization alone, 1.9% of patients undergoing hepatic artery chemoinfusion, and 4.1% of patients undergoing hepatic artery embolization followed by chemoinfusion. Four patients had infectious complications that included four episodes each of cholangitis, liver abscess, and septicemia. One patient developed a subphrenic abscess in addition to a liver abscess. Enteric gram-negative bacilli (aerobic and anaerobic) were isolated from all four patients. None of the patients had received prophylactic antibiotics. All patients responded to antimicrobial therapy and percutaneous drainage of abscesses.