Masaki Ishikawa MD, Presenter: Nothing to Disclose

Hideaki Kakizawa, Abstract Co-Author: Nothing to Disclose

Masashi Hieda, Abstract Co-Author: Nothing to Disclose

Kenji Kajiwara MD, Abstract Co-Author: Nothing to Disclose

Keizo Tanitame MD, Abstract Co-Author: Nothing to Disclose

Kazuo Awai MD, Abstract Co-Author: Nothing to Disclose

Chihiro Tani, Abstract Co-Author: Nothing to Disclose

In patients with a replaced right hepatic artery (RHA), indwelling catheters of a reservoir system using a 5-Fr catheter for hepatic arterial infusion chemotherapy (HAIC) are not indicated because of frequent RHA occlusion. We delivered HAIC using a coaxial catheter reservoir system (CCRS) and a 2.5-Fr microcatheter without a fixed catheter tip (FCT) to avoid arterial occlusion in patients with a replaced RHA. In our retrospective study we analyzed the success rate, patency duration of the catheter, and complications of this treatment method.

In 26 sessions (19 male, mean age 62.5 years), underwent the insertion of 25 CCRS into the replaced RHA in 26 sessions. The replaced RHAs originated from the SMA (20 sessions), the celiac artery (n=4), and the abdominal aorta (n=2). Catheter dislocation was categorized as unacceptable, resulting in discontinuation of HAIC, or as acceptable with continuation of HAIC. We retrospectively analyzed the technical success rate, the patency duration of the catheter, and complications attributable to CCRS.

CCRSs were successfully implanted in 25 of 26 sessions with no major complications during the procedure. One failure was due to severe stenosis at the origin of the replaced RHA; a reservoir system using a 5-Fr catheter had been implanted earlier into the replaced RHA. The median catheter patency was 65.5 days (range 13-1344). Complications included hemorrhage around the port (2 sessions), CCRS occlusion (n=1), and occlusion of the replaced RHA (n=1). In 5 sessions (5 systems) we encountered acceptable catheter dislocation; there were no instances of unacceptable dislocation requiring repositioning.

Implantation with CCRS using a 2.5-Fr microcatheter without FCT achieved a high success rate and low frequency of occlusion of RHA, and did not elicit unacceptable dislocation of the catheter system in patients with replaced RHA.

Implantation of CCRS using a 2.5-Fr microcatheter without FCT is useful for HAIC in patients with a replaced RHA.

Ishikawa, M, Kakizawa, H, Hieda, M, Kajiwara, K, Tanitame, K, Awai, K, Tani, C, Hepatic Arterial Infusion Chemotherapy in Patients with Replaced Right Hepatic Artery Replacement: Implantation of a Coaxial Reservoir System Using a 2.5-Fr Microcatheter without Catheter Tip Fixation.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002950.html