THE TOTALLY IMPLANTABLE MINIMALLY INVASIV E HEPATIC-ARTERY CATHETER FOR INTRAARTERIAL CHEMOTHERAPY OF UNRESECTABLE LIVER METASTASES IN CASES OF DYSFUNCTION OF ARTERIAL ACCESS DEVICES

Dysfunction of arterial access devices used in accociation with intra- arterial chemotherapy for the treatment of unresectable liver metastas es usually requires stopping the therapy or relaporotomy and reimplant ation of a new arterial catheter. OUT initial experience technique, th e so-called MIAH catheter (minimally invasive hepatic artery catheter) in 36 patients (age 37-78 years) are reported. The MIAH catheter was percutanously inserted into the subclavian artery under sonographic gu idance and advanced via the descending aorta selectively into the hepa tic artery. Finaly it was connected to a totally implantable pump. The re were no deaths related to the operation. Operative or early complic ations occurred in 5 cases (13.8%) late complications were seen in 13 patients (36.1%). Nevertheless continuation of intraarterial chemother apy was possible in all cases. In cases of dysfunction of conventional arterial access devices the MIAH catheter makes it possible to contin ue intra-arterial chemotherapy without requiring laporotomy.