Percutaneous femoral implantation of an arterial port catheter for intraarterial chemotherapy: Feasibility and predictive factors of long-term functionality

Frederic Deschamps, Pramod Rao, Christophe Teriitehau, Antoine Hakime, David Malka, Valerie Boige, Michel Ducreux, Dominique Elias, Diane Goere, Thierry De Baere

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55 Scopus citations

Abstract

Purpose To evaluate the feasibility, functionality, and dysfunctions of an arterial port catheter implanted via the femoral artery. Materials and Methods From November 2001 to May 2008, 93 consecutive patients (mean age 57 years old) with unresectable hepatic colorectal metastases were referred for intraarterial chemotherapy. The arterial port catheters were percutaneously implanted via the femoral artery. The catheter tips were placed as "free-floating" in the common hepatic artery (technique 1), "fixed" in the gastroduodenal artery (technique 2), or inserted in a segmental hepatic artery (technique 3). Embolization of the right gastric artery was always attempted. Results The technical success rate of the femoral approach was 94% (n = 88 of 93). Intraarterial chemotherapy (average 7.3 courses) was administered to 84 patients. Migration and occlusion of the catheters occurred in 12% (n = 10 of 84) and 11% (n = 9 of 84) of patients, and extrahepatic perfusion occurred in 30% (n = 25 of 84) of patients. Catheter migration occurred significantly more frequently with technique 1 (50%; n = 3 of 6) than with technique 2 (11%; n = 7 of 64; P = .03) or technique 3 (0%; n = 0 of 14; P = .02). Occurrence of gastroduodenal ulcerations was significantly lower (P = .01) when embolization of the right gastric artery was performed (8%; n = 4 of 48) than when it was not (28%; n = 11 of 36). The success rate of embolization of the right gastric artery significantly improved (P = .006) from the first half of patients treated to the second half, resulting in a significant (P = .02) decrease in the occurrence of ulcerations from 28% (n = 12 of 42) in the first half of patients treated to 7% (n = 3 of 42) in the second half. Conclusions Percutaneous femoral placement of an arterial port catheter is highly feasible. Right gastric artery embolization and use of techniques 2 and 3 are good predictive factors for long-term functionality.

Original languageEnglish
Pages (from-to)1681-1688
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume21
Issue number11
DOIs
StatePublished - Nov 2010
Externally publishedYes

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