Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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A Simplified Technique of Percutaneous Hepatic Artery Port-Catheter Insertion for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Invasion

  • Choi, Sun-Young (Department of Radiology, Hallym University Sacred Heart Hospital) ;
  • Kim, Ah-Hyun (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, University of Yonsei, College of Medicine) ;
  • Kim, Kyung-Ah (Department of Radiology, Inje University Ilsan Paik Hospital) ;
  • Won, Jong-Yun (Department of Radiology, Gangnam Severance Hospital, University of Yonsei, College of Medicine) ;
  • Lee, Do-Yun (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, University of Yonsei, College of Medicine) ;
  • Lee, Kwang-Hun (Department of Radiology and Research Institute of Radiological Science, Severance Hospital, University of Yonsei, College of Medicine)
  • Received : 2010.06.03
  • Accepted : 2010.07.01
  • Published : 2010.12.01
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Abstract

Objective: We assessed the outcomes of a simplified technique for the percutaneous placement of a hepatic artery port-catheter system for chemotherapy infusion in advanced hepatocellular carcinoma with portal vein invasion. Materials and Methods: From February 2003 to February 2008, percutaneous hepatic artery port-catheter insertion was performed in 122 patients who had hepatocellular carcinoma with portal vein invasion. The arterial access route was the common femoral artery. The tip of the catheter was wedged into the right gastroepiploic artery without an additional fixation device. A side hole was positioned at the distal common hepatic artery to allow the delivery of chemotherapeutic agents into the hepatic arteries. Coil embolization was performed only to redistribute to the hepatic arteries or to prevent the inadvertent delivery of chemotherapeutic agents into extrahepatic arteries. The port chamber was created at either the supra-inguinal or infra-inguinal region. Results: Technical success was achieved in all patients. Proper positioning of the side hole was checked before each scheduled chemotherapy session by port angiography. Catheter-related complications occurred in 19 patients (16%). Revision was achieved in 15 of 18 patients (83%). Conclusion: This simplified method demonstrates excellent technical feasibility, an acceptable range of complications, and is hence recommended for the management of advanced hepatocellular carcinoma with portal vein thrombosis.

Keywords

References

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