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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

 Sun Young Choi  ;  Ah Hyun Kim  ;  Kyung Ah Kim  ;  Jong Yun Won  ;  Do Yun Lee  ;  Kwang-Hun Lee 
 KOREAN JOURNAL OF RADIOLOGY, Vol.11(6) : 648-655, 2010 
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Angiography ; Antineoplastic Agents/administration & dosage* ; Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/pathology ; Catheters, Indwelling*/adverse effects ; Embolization, Therapeutic ; Female ; Femoral Artery/surgery ; Fluoroscopy ; Hepatic Artery* ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Portal Vein/pathology* ; Radiography, Interventional* ; Treatment Outcome
Hepatic arterial catheterization ; Liver cancer ; Percutaneous catheter placement
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.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
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