Percutaneous implantation of a port-catheter system using the left subclavian artery

Purpose: To evaluate the safety and feasibility of a percutaneous Port-Cath eter System (PCS) implanted via the subclavian artery (SCA) for regional ch emotherapy or chemoembolization of thoracic, abdominal, and pelvic malignan t tumors. Methods: Percutaneous puncture of the SCA was performed in 256 patients wit h thoracic, abdominal, or pelvic malignant tumors; then a catheter was inse rted into the target artery. After the first transcatheter chemotherapy or chemoembolization with an emulsion of lipiodol and anticancer agents, an in dwelling catheter was introduced with its tip placed in the target artery a nd its end subcutaneously connected to a port. Results: The procedure was successfully completed in all 256 cases (100%). The indwelling catheter tip was satisfactorily placed in the target arterie s in 242 cases (98%). Complications attributable to the procedure occurred in 20 (7.8%) cases, including pneumothorax (n = 10, 4%), hemothorax (n = 1, 0.4%), infections in the pocket (n = 4, 1.6%), and hematoma at the puncture site (n = 5, 2%). There were no severe sequelae or deaths. The duration of PCS usage was 1-36 months (median 9.5 months). During the course of treatm ent, occlusion of the target artery occurred in 20 cases (7.8%). Dislocatio n of the tip of the indwelling catheter occurred in 12 cases (4.7%); in 10 of the 12, the tip of the indwelling catheter was repositioned into the tar get artery. In all 10 cases no large symptomatic hematomas developed after the PCS was removed. Conclusion: Percutaneous PCS implantation via the left SCA, a relatively ne w procedure, is a safe and less invasive treatment approach than surgical p lacement for malignancies.