Document Detail

Arterial embolization for salvage of hepatic artery infusion pumps.
MedLine Citation:
PMID:  16687745     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Hepatic artery infusion pumps (HAIPs) ideally provide for homogenous perfusion of the liver with chemotherapeutic agents. Perfusion of extrahepatic organs or asymmetric liver perfusion (ie, "misperfusion") is diagnosed by nuclear scintigraphy and precludes the use of HAIPs. The purpose of this study is to report experience in salvaging HAIPs with arterial embolization. MATERIALS AND METHODS: A single-center HAIP database was retrospectively reviewed for cases from 1999 to 2005 to identify patients who underwent angiography to treat misperfusion documented by nuclear scintigraphy. Patient demographics, nuclear scintigraphic findings before and after embolization, angiographic findings, embolization variables, and outcomes were recorded. Technical success (defined by cessation of flow to the vessel responsible for misperfusion) and clinical success (ie, successful use of the pump) were calculated. RESULTS: During the study period, 475 HAIPs were implanted. Of those, 43 (9%) had abnormal nuclear scintigraphic findings of misperfusion, but only 32 (7%) had angiographic abnormalities. In eight of 32 cases, hepatic arterial thrombosis and extravasation at the catheter tip were found, which precluded salvage by embolization. In 24 of 32 cases, a vessel presumed responsible for the misperfusion was identified and targeted for embolization. Technical success and clinical success were achieved in 21 of 24 patients (87.5%) and 19 of 24 patients (79%), respectively, who underwent 27 embolization procedures. The three technical failures (12.5%) were the result of inability to catheterize the identified vessel. CONCLUSIONS: Percutaneous arterial embolization of a vessel to correct misperfusion shown by nuclear scintigraphy is safe and effective. This approach can be expected to result in HAIP salvage in the majority of patients.
Constantinos T Sofocleous; Johanna Schubert; Nancy Kemeny; Anne M Covey; Lynn A Brody; George I Getrajdman; Raymond Thornton; Corinne Winston; Karen T Brown
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  17     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-11     Completed Date:  2006-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  801-6     Citation Subset:  IM    
Division of Interventional Radiology and Image-Guided Therapies, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA.
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MeSH Terms
Antineoplastic Agents / administration & dosage
Colorectal Neoplasms / pathology
Embolization, Therapeutic / methods*
Hepatic Artery / pathology*
Infusion Pumps, Implantable / adverse effects*
Infusions, Intra-Arterial / adverse effects*
Liver / radiography,  radionuclide imaging*
Liver Neoplasms / drug therapy,  secondary
Middle Aged
Postoperative Complications / therapy*
Retrospective Studies
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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