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Placement of a Long Tapered Side-Hole Catheter in the Hepatic Artery: Technical Advantages, Catheter Stability, and Arterial Patency

Hiroshi Seki1 and Makoto Shiina1

1 Both authors: Department of Radiology, Niigata Cancer Center Hospital, 2-15-3, Kawagishi-cho, Niigata 951-8566, Japan.


Figure 1
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  		Fig. 1A —60-year-old man with liver metastases from sigmoid colon cancer. Celiac arteriogram obtained before catheter placement shows right gastric artery (arrows) and accessory left gastric artery (arrowheads) arising from proper hepatic artery.

 

Figure 2
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  		Fig. 1B —60-year-old man with liver metastases from sigmoid colon cancer. Abdominal radiograph obtained just after catheter placement shows 2.7-French distal shaft of catheter in celiac artery and 5-French proximal shaft in aorta. Catheter tip is advanced distally into right hepatic artery and side hole of distal shaft is located in proper hepatic artery (arrow).

 

Figure 3
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  		Fig. 1C —60-year-old man with liver metastases from sigmoid colon cancer. Arteriogram using catheter-port system obtained just after implantation shows no extrahepatic perfusion and no embolization of gastroduodenal artery, and occlusion of right gastric artery (arrow) and accessory left gastric artery (arrowhead) using coils.

 

Figure 4
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  		Fig. 2A —61-year-old woman with liver metastases from rectal cancer who previously underwent left hepatic lobectomy. Arteriogram obtained before catheter placement shows replaced right hepatic artery arising from superior mesenteric artery.

 

Figure 5
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  		Fig. 2B —61-year-old woman with liver metastases from rectal cancer who previously underwent left hepatic lobectomy. Arteriogram using catheter-port system was obtained just after implantation. Long tapered side-hole catheter was inserted into replaced right hepatic artery. Arterial branch of caudate lobe of liver arising from proper hepatic artery was occluded using coils (arrow).

 

Figure 6
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  		Fig. 3 —Graph shows Kaplan-Meier analysis for cumulative stability of catheter according to catheter placement method. {blacktriangleup} = long tapered catheter placement method, censored cases; {circ} = conventional method, censored cases; X = fixed-catheter-tip method, censored cases. Stability rates in patients treated with long tapered catheter placement method were significantly higher than those for patients treated with conventional method (p = 0.0208 using log-rank test) but were similar to rates for those treated with fixed-catheter-tip method.

 

Figure 7
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  		Fig. 4 —Graph shows Kaplan-Meier analysis to determine cumulative patency of hepatic artery according to catheter placement method. {blacktriangleup} = long tapered catheter placement method, censored cases; {circ} = conventional method, censored cases; X = fixed-catheter-tip method, censored cases. Patency rates for patients treated with long tapered catheter placement method were significantly higher than those for patients treated with conventional method (p = 0.0066 using log-rank test) but were not statistically different from those treated with fixed-catheter-tip method.

 

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