Transbrachial hepatic arterial chemotherapy using an implanted infusion pump

Abstract

Two patients with hepatic metastases from colonic cancer were treated with hepatic arterial FUDR [5-fluorouracil] using an innovative drug infusion system. The 2 patients reported underwent transbrachial hepatic artery catheterization with a 5 French polyethylene catheter. This catheter was amputated just distal to its exit from the brachial artery and attached to a totally implantable, percutaneously refillable drug infusion pump placed in the infraclavicular position. The patients received FUDR at flow rates of 3-4 ml/day. The pumps were refilled weekly by percutaneous injection. One patient was treated for 7 wk and another for 10 wk without technical difficulties. This innovative approach offers marked improvement in comfort and convenience for patients who are candidates for long-term hepatic artery chemotherapy, and avoids the morbidity of laparotomy for direct hepatic arterial catheterization.