Percutaneous long-term arterial access with implantable ports. Direct subclavian approach with US

To clarify the clinical feasibility of getting a long-term arterial access at the subclavian region by directly puncturing the artery under ultrasound guidance.

Percutaneous placements of arterial infusion catheters with implantable ports were performed in 30 patients with malignant abdominal tumors. The axillary artery in the subclavian region was punctured directly with an 18G needle under ultrasound guidance. Using the Seldinger technique, a 5Fr catheter was placed with its tip in the hepatic or the other tumor-supplying arteries. The catheter was connected to an implantable port, and both of them were embedded in the subcutaneous pocket.

Percutaneous placements of infusion catheters were successfully performed in 29 cases. Transarterial chemotherapy through implanted ports was done uneventfully in 26 patients, while in the other three cases, catheter dislodgment occurred. Two local haematomas, one wound infection and one cerebellar infarction were also experienced.

Ultrasound-guided subclavian approach is a minimally invasive way of implanting an infusion catheter for chemotherapy, although its indication for severely atherosclerotic patients should be limited.