COMPLICATIONS AND TECHNICAL LIMITATIONS OF HEPATIC ARTERIAL INFUSION CATHETER PLACEMENT FOR CHEMOTHERAPY

PURPOSE: To determine the rate of complications associated with hepati c arterial infusion (HAI) catheter placement, as well as technical suc cess related to Liver perfusion. MATERIALS AND METHODS: The authors re viewed 44 patients who underwent 106 HAI catheter placements, includin g 15 men and 29 women with an average age of 55 years (range, 32-82 ye ars), One to nine placements were performed per patient with 61 (58%) via the left brachial artery, 40 (38%) via the right femoral artery, a nd five (4%) via the left femoral artery, Chemoinfusion lasted 4 days, with initial catheter placement assessed on technetium-99m macroaggre gated albumin (NIAA) perfusion scans, as well as daily abdominal radio graphs. RESULTS: One hundred attempted hepatic arterial catheter place ments were completed, Liver perfusion was global in 66 (66%) cases, in the right lobe only in 28 (28%) cases, and in the left lobe only in s ix (6%) cases, Eight (8%) had gastrointestinal (GI) tract perfusion; t his was eliminated in seven cases (7%) after catheter repositioning, F orty-six (43%) placement attempts required embolization of 62 GI vesse ls to preclude GI chemoinfusion. Complications included one cerebrovas cular accident (related to removal of a left brachial catheter), eight brachial artery thromboses (four that required emergent thrombectomy) , six hepatic arterial dissections, four hepatic arterial thromboses, and four catheter malfunctions. CONCLUSIONS: HAI catheter placement vi a the left brachial artery has increased complications, Nearly one-hal f of placements required embolization of GI vessels to preclude GI per fusion, Global perfusion is possible in two-thirds of cases.