Document Detail

Transcatheter embolization for the treatment of misperfusion after hepatic artery chemoinfusion pump implantation.
MedLine Citation:
PMID:  10379855     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The use of surgically implanted chemoinfusion pumps for the treatment of hepatic metastases from colorectal carcinoma can be complicated by intra- or extrahepatic misperfusion. This may result in suboptimal tumor exposure to the chemotherapeutic agent and injury to other gastrointestinal organs. Misperfusion can be managed by selective arterial transcatheter embolization. METHODS: Between 1989 and 1996, 16 patients with liver metastases from colorectal carcinoma and with hepatic artery chemoinfusion pump misperfusion were treated using transcatheter coil embolization. Six female and 10 male patients (age range, 34-84 years; median, 51.5 years) were identified by retrospective review of the records of the Department of Interventional Radiology. After pump placement, abnormal liver perfusion scan or methylene blue endoscopy study results prompted angiography with coil embolization. After embolization, the imaging studies were repeated and patients were monitored in the Oncology Clinic. RESULTS: Eight patients exhibited intrahepatic misperfusion (group 1) and eight extrahepatic misperfusion (group 2). Coil embolization was immediately successful in 100% of patients in group 1, with restoration of normal hepatic perfusion, and in 75% in group 2. There were no immediate procedure-related complications. Follow-up periods ranged from 1 to 23 months (median, 13.5 months). Embolization was unsuccessful for two patients (in group 2), who tolerated a modified chemotherapeutic regimen, with follow-up periods of 18.5 and 22 months. CONCLUSIONS: Transcatheter coil embolization is the therapy of choice for the management of hepatic artery chemoinfusion pump misperfusion. It is rapid, effective, and well tolerated by patients and obviates the need for additional surgical intervention.
A I Bloom; R L Gordon; K H Ahl; R K Kerlan; J M LaBerge; M W Wilson; A P Venook; R Warren
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Annals of surgical oncology     Volume:  6     ISSN:  1068-9265     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-08-17     Completed Date:  1999-08-17     Revised Date:  2007-07-18    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  350-8     Citation Subset:  IM    
Department of Interventional Radiology, University of California, San Francisco 94143-0628, USA.
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MeSH Terms
Aged, 80 and over
Colorectal Neoplasms / pathology
Embolization, Therapeutic* / methods
Follow-Up Studies
Hepatic Artery*
Infusion Pumps, Implantable*
Infusions, Intra-Arterial / adverse effects*
Liver Neoplasms / drug therapy*,  secondary*
Middle Aged
Retrospective Studies
Technetium Tc 99m Aggregated Albumin / diagnostic use
Technetium Tc 99m Sulfur Colloid / diagnostic use
Treatment Outcome
Reg. No./Substance:
0/Technetium Tc 99m Aggregated Albumin; 0/Technetium Tc 99m Sulfur Colloid
Comment In:
Ann Surg Oncol. 1999 Jun;6(4):328-9   [PMID:  10379851 ]

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