Using n-butyl cyanoacrylate and the fixed-catheter-tip technique in percutaneous implantation of a port-catheter system in patients undergoing repeated hepatic arterial chemotherapy
Using n-butyl cyanoacrylate and the fixed-catheter-tip technique in percutaneous implantation of a port-catheter system in patients undergoing repeated hepatic arterial chemotherapy
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DOI：
10.2214/ajr.179.6.1791611
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发表时间：
2002-12-01
影响因子：
5
通讯作者：
Nishimura, T
中科院分区：
文献类型：
--
作者：
Yamagami, T;Iida, S;Nishimura, T
OBJECTIVE.我们研究的目的是评估在微弹簧圈中添加氰基丙烯酸正丁酯以固定导管尖端在经皮植入肝动脉灌注化疗的输液港导管系统中的有用性。对象和方法。93名患有不可切除的晚期肝癌的患者（64名男性和29名女性;年龄范围，38-83岁;平均年龄，62.2岁）接受了经皮植入输液港-导管系统，导管头端用微弹簧圈和氰基丙烯酸正丁酯和碘化油的混合物固定在胃十二指肠动脉处。本文对与该技术密切相关的植入成功率、并发症及并发症的处理进行了综述。所有患者均成功进行了经皮输液港导管置入。然而，8例患者发生了并发症：肝动脉阻塞（n = 5，5.4%）;导管脱位（n = 2，2.2%）;胃十二指肠动脉再通（n = 1，1.1%）;或氰基丙烯酸正丁酯移动（n = 1，1.1%）。在8例并发症患者中，有5例在观察患者以确保稳定性或使用相对容易的介入技术治疗后继续肝动脉灌注化疗。在93例患者中，有3例（3.2%）由于与该技术相关的并发症而无法进行计划的肝动脉灌注化疗。使用微弹簧圈和氰基丙烯酸正丁酯和碘化油的混合物将导管头端固定在胃十二指肠动脉中，是经皮药盒导管放置用于重复肝动脉灌注化疗的一种有用且安全的技术。
OBJECTIVE. The purpose of our study was to evaluate the usefulness of adding n-butyl cyanoacrylate to microcoils to fix the catheter tip in percutaneous implantation of a port-catheter system for hepatic arterial-infusion chemotherapy.SUBJECTS AND METHODS. Ninety-three patients (64 men and 29 women; age range, 38-83 years; mean age, 62.2 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system with the catheter tip fixed at the gastroduodenal artery with microcoils and a mixture of n-butyl cyanoacrylate and iodized oil. The rates of successful implantation and complications closely associated with this technique and management of the complications were reviewed.RESULTS. Percutaneous port-catheter placement was successfully performed in all patients. However, in eight patients, complications occurred: hepatic arterial obstruction (n = 5, 5.4%); catheter dislocation (n = 2, 2.2%); recanalization of the gastroduodenal artery (n = 1, 1.1%); or movement of n-butyl cyanoacrylate (n = 1, 1.1%). In five of the eight patients with complications, hepatic arterial-infusion chemotherapy was continued either after observation of the patient to ensure that stability had been established or after treatment using comparatively easy interventional techniques. In three (3.2%) of the 93 patients, planned hepatic arterial-infusion chemotherapy could not be performed because of complications associated with the technique.CONCLUSION. Fixation of the catheter tip in the gastroduodenal artery using a combination of microcoils and a mixture of n-butyl cyanoacrylate and iodized oil is a useful and safe technique in percutaneous port-catheter placement for repeated hepatic artetial infusion chemotherapy.