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Since intra-arterial chemotherapy with the help of implantation of port-catheter system (PCS) was first used in the surgical field in 1981, PCS has been widely employed in the field of interventional radiology. Intra-arterial chemotherapy by implantation of PCS has some certain advantages such as minimal invasion, no need of general anesthesia, etc. Ten randomized clinic trails have been already reported, which indicate that intra- arterial chemotherapy with PCS is obviously superior to systemic chemotherapy in treating hepatic metastasis form colorectal cancer. As for the treatment of advanced biliary tract cancer, pancreatic carcinoma and hepatocellular carcinoma, the relevant reports can be found only in several phaseⅠ/Ⅱclinical trials or in some retrospective cohort studies. This paper aims to make a comprehensive review about the indications, clinical applications and complications of PCS in treating abdominal tumors in order to improve the clinical practice.
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Medication is still the main means for treating liver cirrhosis. However, micro-circulation obstacle in the liver and dynamic abnormality of portal vein flow suggest that liver protecting drugs via peripheral veins can hardly give full requirement for their effect. The authors reviewed a new method of percutaneous transhepatic portal vein implantation of port-catheter system for infusion of drugs in the treatment of liver cirrhosis, with theoretical basis and the outlook of application.
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Objective To introduce the methods,complications and management of transiliaca external artery port catheter system (PCS) implantation,and to discuss its feasibility and superiority. Methods Transiliaca external artery PCS implantation were performed in 110 patients with medium or advanced malignant hepatic tumor.There were 86 male and 24 female, with average 50.8 years old, including 68 cases primary hepatic cancer, 42 cases metastatic cancer. Follow-up time was 2～53 months. Results The operation successful rate was 98.2% (108/110). Complications included: puncture local hematoma in 5 cases (4.5%), cut infection in 1 case (0.9%), slow bleeding in cut in 2 cases (1.8%), light swelling and paining of right testicle in 1 case (0.9%), target arteries occlusion or serious narrowness in 6 cases (5.5%), displacement of the tip of catheter in 3 cases (2.7%). Complications rate was 15.5% (17/110).Conclusion Transiliaca external artery PCS implantation is safe and feasible, the successful rate is higher and complications rate is lower, it can be introduced as a sort of routine method.
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Objective To evaluate the clinical feasibility and validity of interventional therapy in thrombo angitis obliterans. Methods 13 patients with thrombo angitis obliterans were treated with percutaneous left subclavian artery port catheter system implantation. The catheter external iliac artery with perfusion of prostaglandin E1 (PGE1) 100Ug, urokinase (UK) 200,000U and mailuoning 20 ml every day. Each treatment lasted for 7 10 days. Results 13 patients with angiographic demonstration showed occlusions of 1 case in the middle segment of superficial femoral artery, 9 cases of complete occlusion in popliteal artery and same for 3 cases in anterior tibial artery, the end of the peroneal artery and posterior tibial artery. After treatment, 3 patients had to undergo amputation due to gangrene in foot and 10 patients with no gangrene showed skin temperature rising up in the lower limb. Intermittent claudication and rest pain were relieved obviously accompanied by increasing step distance over 500 m with the Fontain grade improvement of twice at least. Follow up angiography one year later showed large quantity of vasculogenesis in the lower limb. Conclusion The treatment of trans port catheter system is excellent and practical for improving the clinical status of patients with thrombo angitis obliterans.
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Purpose: To investigate the security and clinical value of percutaneous intravascular home-made port-catheter-system(PCS) implatation. Materials and Methods: This technique was used to treat thoracic, abdominal and pecvic malignant tuwcors in 63 patients. Intra-arterial injection of anticancerous agents and lipiodol were regularly carried out Via PCS. Results: All PCS implatation were successful. The PCS catheter tips were all retained within target vessels. The related complications in- cluded local hemorrhage (5 cases, 7.9%), wound delaged healing or wound dehiscence (4 cases, 6. 3%), indwelling catheter blockage (4 cases, 6. 3%), migrating of catheter tip (1case, 1.5%), local infection (2cases, 3.1%). Most of these cases were recovered after appropriate management without any fatal and pevae sequelae. Conclusion: Percutaneous Intravascular home-made port-eatheter system implantation is safe and reliable. Home-made PCS is cheaper and more suitable for chinese than im- ported products.
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OBJECTIVE:To evaluate the clinical outcome of arterial perfusion with chemotherapy medicine together with elemenum emulsion injection solution via Port-Catheter System(PCS)in treating middle-late malignant tumors.METHODS:A total of63patients with middle-late malignant tumors were enrolled,31were randomly assigned to receive arterial perfusion of chemotherapeutics in combination with elemenum emulsion(group A),and32cases to receive single arterial perfusion of chemotherapeutics(group B),the short-term curative effects of the2groups were then compared.RESULTS:The total effec_ tive rate of group A and B were66.7%and46.7%,respectively with one-year survival of which respectively at56.7%and43.3%.There was significant difference between two groups(P