Complications encountered with a transfemorally placed port-catheter system for hepatic artery chemotherapy infusion

A port-catheter system was implanted via femoral artery access for hepatic artery chemotherapy infusion. Implantation was attempted in 90 patients and was successful in 88. Blood flow redistribution was performed using emboli zation coils. In the first ten patients a soft heparin-coated infusion cath eter was used. For the following 78 patients we used a stiffer catheter coa ted with fluorine-acryl-styrene-urethane-silicone (FASUS) copolymer. The ca theter was connected to a port implanted subcutaneously below the level of the inguinal ligament. Complications during the procedure and after placeme nt were observed in 7 of 90 patients and 24 of 88 patients, respectively. T hese included catheter obstruction (11%), dislocation of the catheter tip ( 10%), drug toxicity (5.7%), and catheter infection (3.4%). In 6 of 10 patie nts with catheter obstruction, recanalization of the port system was achiev ed. In 7 of 9 patients with dislocation of the indwelling catheter tip, rep lacement of the port system was successful. Our complications appear to be comparable with those encountered with the subclavian/brachial approach whe n the new catheter coating is used. Notable is the avoidance of cerebral in farcts.