국소적 약물주입을 위한 경피적 동맥내 포트삽입술: 110예의 결과와 합병증

Abstract

PURPOSE: To investigate the feasibility and complications of a percutaneously implantable port system for regional drug infusion. MATERIALS AND METHODS: For intra-arterial drug infusion, a 5.8 or 5-F pediatric venous port system was implanted in 110 patients with hepatocelluar carcinoma (n = 79), liver metastasis (n = 16), gallbladder cancer (n = 4), stomach cancer (n = 3), pancreatic cancer (n = 3), Burger's disease (n = 2), diabetes mellitus (n = 2), or lymphoma (n = 1). All intra-arterial port implantations were performed percutaneously in an angiographic ward through the common femoral artery (n = 98), left subclavian artery (n = 10), or left superficial femoral artery (n = 2). Complications were evaluated during the follow-up period, which ranged from 21 to 530 (mean, 163) RESULTS: The technical success rate for percutaneous implantation of the system was 97.3% (107 of 110 patients). The tips of the port catheter were located in the common hepatic artery (n = 34), proper hepatic artery (n = 49), right hepatic artery (n = 8), left hepatic artery (n = 1), descending aorta at T9 level (n = 10), left popliteal artery (n = 2), right external iliac artery (n = 1), left external iliac artery (n = 1), or left deep femoral artery (n = 1). Complications were encountered in 24 patients(22.4%), namely chamber site infection (n = 7), catheter dislodgement (n = 7), catheter occlusion (n = 3), migration of coil (n = 2), disconnection between chamber and catheter (n = 1), kinking of catheter (n = 1), arterial occlusion (n = 1), necrosis of overlying skin (n = 1), and leakage around port chamber (n = 1). Outcomes of complications included removal of port systems or cessation of therapy in 12 cases (11.2%), correction of catheter location using a guide wire in five (4.7%), thrombolysis with urokinase in three (2.8%), and straightening using a snare in one (0.9%). In three patients, the port system was used without reintervention. CONCLUSION: Percutaneous implantation of an intra-arterial port system showed a high technical success rate and a low rate of serious complications. The method may be useful for regional drug infusion in various