Laparoscopic radiofrequency ablation and hepatic artery infusion pump placement in the evolving treatment of colorectal hepatic metastases

2003 ◽  
Vol 17 (1) ◽  
pp. 61-67 ◽  
Author(s):  
J. Cheng ◽  
R.E. Glasgow ◽  
R.W. O'Rourke ◽  
L.L. Swanstrom ◽  
P.D. Hansen
Keyword(s):  
Radiofrequency Ablation ◽  
Hepatic Artery ◽  
Infusion Pump ◽  
Hepatic Metastases ◽  
Hepatic Artery Infusion ◽  
Laparoscopic Radiofrequency Ablation ◽  
Pump Placement ◽  
Colorectal Hepatic Metastases

scholarly journals Evaluation of Hepatic Artery Infusion Chemotherapy after Hepatectomy for Colorectal Hepatic Metastases.

2000 ◽  
Vol 33 (2) ◽  
pp. 169-175
Author(s):  
Yasushi Suzuki ◽  
Masashi Watanabe ◽  
Makoto Kikuchi ◽  
Yukitake Hasebe ◽  
Haruhiro Nakazaki ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Hepatic Metastases ◽  
Hepatic Artery Infusion ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy ◽  
Colorectal Hepatic Metastases

Su1530 Robotic Hepatic Artery Infusion Pump Placement

2016 ◽  
Vol 150 (4) ◽  
pp. S1217
Author(s):  
Motaz Qadan ◽  
Michael D'Angelica ◽  
Peter Allen ◽  
Ronald P. DeMatteo ◽  
William R. Jarnagin ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Infusion Pump ◽  
Hepatic Artery Infusion ◽  
Pump Placement

scholarly journals The Effects on Liver Metastases of Circadian Patterned Continuous Hepatic Artery Infusion of FUDR

HPB Surgery ◽  
1994 ◽  
Vol 7 (3) ◽  
pp. 219-224 ◽  
Author(s):  
M. Margaret Kemeny ◽  
Galo Alava ◽  
Jorge M. Oliver
Keyword(s):  
Hepatic Artery ◽  
Objective Response Rate ◽  
Response Rate ◽  
Objective Response ◽  
Hepatic Metastases ◽  
Colon Adenocarcinoma ◽  
Constant Infusion ◽  
Hepatic Artery Infusion ◽  
Antitumor Effects ◽  
Colorectal Hepatic Metastases

Although continuous hepatic artery infusions (CHAI) of (FUDR) Floxuridine have been effective in reducing the size of colorectal hepatic metastases the toxicity of the infusions have been high with almost a quarter of the patients developing biliary sclerosis. Techniques to lower toxicity, yet continue the beneficial antitumor effects, are being investigated. One suggested strategy is to change the flow pattern of the continuous infusion from a constant rate to a day cycled pattern. In this infusion a continuous rate is given over a 24 hour period with 60% of the infusion delivered between 3 PM and 9 PM and the least amount of infusion delivered between 3 AM and 9 PM. Previous research has suggested that this day cycle pattern will lower the toxicity of the infusion. This experiment is a test of “day cycled” continuous hepatic artery infusions in rats bearing hepatic metastases from a colon adenocarcinoma. Previous research from our laboratory has shown a lowered toxicity when the constant infusion was replaced with the day cycled pattern.In the present study 10 rats with hepatic adenocarcinoma metastases were placed on constant CHAI of FUDR at 10mg/kg/day for 14 days. There was an 80% mortality from chemotherapy toxicity and a 90% objective response rate. Nine other rats were treated with “day cycled” CHAI of FUDR at 15mg/kg/d. There was no mortality in this group and the objective response rate was 90% as in the previous group. This study demonstrated that “day cycled” CHAI of FUDR was substantially less toxic and that the antitumor effect was identical to the constant infusion.

scholarly journals 553. Outbreak of Methicillin-Resistant Staphylococcus aureus Associated with Hepatic Artery Infusion Pumps

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S263-S263
Author(s):  
Christopher Calero ◽  
Shauna Usiak ◽  
Anoshé Aslam ◽  
Margaret A Palazzolo ◽  
Tracy McMillen ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Infusion Pump ◽  
Hepatic Metastases ◽  
Direct Care ◽  
Healthcare Personnel ◽  
Common Source ◽  
Hepatic Artery Infusion ◽  
Snp Analysis ◽  
Vascular Access Devices ◽  
Outbreak Management

Abstract Background Device-related infections account for a fourth of all HAIs. Hepatic artery infusion pump (HAIP) devices are used to deliver chemotherapy directly into the hepatic artery. This device is used primarily in patients with colorectal cancer for the management of unresectable hepatic metastases. We describe the infection rates and outbreak management of MRSA-related infections in newly placed HAIPs. Methods In December 2018, a cluster of 3 MRSA cases was identified within 15–26 days of HAIP insertion. From January 1, 2017 to December 31, 2018, patients with culture proven SSIs within 30 days of HAIP placement were identified through the infection control database to establish baseline rates. Procedural denominator data were found by querying CPT procedure codes. EMR was reviewed to extract clinical characteristics. In response to the cluster, healthcare personnel (HCP) were screened for MRSA by PCR and environmental cultures performed. PFGE and whole-genome sequencing (WGS) was performed to compare isolates recovered in culture and SNP analysis performed using the BioNumerics software v7.6. Results IIn December 2018, 3/15 patients with HAIP procedures developed MRSA infections within 30 days of the procedures (post-op days: 15,16,26). The baseline 30 day SSI rate for HAIP in 2017 was 1.3% (2/160). No infections, prior to the cluster, in 2017–18 were MRSA related. All patients were male, with a median age of 49 years (range: 45–54). Sixty HCP who provided direct care during the peri and early post-operative period for the 3 cases were screened for MRSA carriage; 2/60 (3.3%) were positive. All 56 environmental cultures were negative for MRSA. WGS of the 3 patient samples showed 2/3 samples were identical (1 SNP difference); confirming common source transmission. Only one HCP isolate was available for WGS and shown to be unrelated to the two patient isolates. Both employees underwent decolonization. Review of HAIP handling did not reveal obvious lapses, but mask use and strict hand hygiene were enforced with HCPs. No further infections have been identified in the 76 procedures since the cluster. Conclusion WGS confirmed common source transmission between two newly placed HAIP although the definitive source could not be identified. Surveillance and prevention efforts should extend to all types of vascular access devices. Disclosures All authors: No reported disclosures.

scholarly journals Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement

2020 ◽  
Vol 27 (13) ◽  
pp. 5098-5106 ◽  
Author(s):  
Brian C. Brajcich ◽  
David J. Bentrem ◽  
Anthony D. Yang ◽  
Mark E. Cohen ◽  
Ryan J. Ellis ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Infusion Pump ◽  
Hepatic Artery Infusion ◽  
Short Term ◽  
Pump Placement

Tumor and liver drug uptake following hepatic artery and portal vein infusion.

1987 ◽  
Vol 5 (11) ◽  
pp. 1836-1840 ◽  
Author(s):  
E R Sigurdson ◽  
J A Ridge ◽  
N Kemeny ◽  
J M Daly
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Hepatic Metastases ◽  
Lactic Dehydrogenase ◽  
Drug Uptake ◽  
Response To Treatment ◽  
Hepatic Artery Infusion ◽  
Colorectal Hepatic Metastases ◽  
The Mean ◽  
Portal Vein Infusion

Anatomic dye injection studies of the blood supply of colorectal hepatic metastases suggest that tumors are supplied predominantly by the hepatic artery. Using 13N amino acids with dynamic gamma camera imaging in patients with colorectal hepatic metastases, it has been shown that hepatic artery infusion results in a significantly greater nutrient delivery to tumor compared with portal vein infusion. However, direct measurements of drug levels in tumor following hepatic artery and portal vein infusion in humans have not previously been reported. Patients with metastatic colorectal cancer confined to the liver received fluorodeoxyuridine (FUdR) through the hepatic artery or through the portal vein. All patients had previously failed systemic chemotherapy. Five patients with hepatic artery catheters were matched (by age, serum lactic dehydrogenase levels, percent hepatic replacement, and tumor size) with five patients with portal vein catheters. At operation, 3H-FUdR (1 microCi/kg) and 99mTc-macroaggregated albumin (MAA) (6 mCi) were injected into the hepatic artery or portal vein. Liver and tumor biopsies were obtained two and five minutes later. 3H and 99mTc were measured per gram tissue by scintillation and gamma counting. The mean liver levels following hepatic artery infusion (23.9 +/- 11.4 nmol/g) and portal vein infusion (18.4 +/- 14.5 nmol/g) did not differ. However, the mean tumor FUdR level following hepatic artery infusion was 12.4 +/- 12.2 nmol/g, compared with a mean tumor FUdR level following portal vein infusion of 0.8 +/- 0.7 nmol/g (P less than .01). This low level of tumor drug uptake after portal vein infusion of FUdR predicts minimal tumor response to treatment via this route. Thus, regional chemotherapy for established colorectal hepatic metastases should be administered through the hepatic artery.

Sign in / Sign up

Export Citation Format

Share Document