Conventional hepatic arterial anatomy? Novel findings and insights of a multi-disciplinary hepatic arterial infusion pump program

2021 ◽  
Author(s):  
Brett S. Walker ◽  
Thomas L. Sutton ◽  
Robert L. Eil ◽  
Elena K. Korngold ◽  
Kenneth J. Kolbeck ◽  
...  
Keyword(s):  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Arterial Anatomy

The management of variant arterial anatomy during hepatic arterial infusion pump placement

2002 ◽  
Vol 9 (9) ◽  
pp. 875-880 ◽  
Author(s):  
Peter J. Allen ◽  
Alexander Stojadinovic ◽  
Leah Ben-Porat ◽  
Mithat Gonen ◽  
David Kooby ◽  
...  
Keyword(s):  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Pump Placement ◽  
Arterial Anatomy

scholarly journals Adjuvant Hepatic Arterial Infusion Pump Chemotherapy After Resection of Colorectal Liver Metastases: Results of a Safety and Feasibility Study in The Netherlands

2019 ◽  
Vol 26 (13) ◽  
pp. 4599-4607 ◽  
Author(s):  
Florian E. Buisman ◽  
Dirk J. Grünhagen ◽  
Marjolein Y. V. Homs ◽  
Cecile Grootscholten ◽  
Wills F. Filipe ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
The Netherlands ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Arterial Bleeding ◽  
Pump Implantation ◽  
Grade Iii

Abstract Background The 10-year overall survival with adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after resection of colorectal liver metastases (CRLMs) was 61% in clinical trials from Memorial Sloan Kettering Cancer Center. A pilot study was performed to evaluate the safety and feasibility of adjuvant HAIP chemotherapy in patients with resectable CRLMs. Study Design A phase II study was performed in two centers in The Netherlands. Patients with resectable CRLM without extrahepatic disease were eligible. All patients underwent complete resection and/or ablation of CRLMs and pump implantation. Safety was determined by the 90-day HAIP-related postoperative complications from the day of pump placement (Clavien–Dindo classification, grade III or higher) and feasibility by the successful administration of the first cycle of HAIP chemotherapy. Results A total of 20 patients, with a median age of 57 years (interquartile range [IQR] 51–64) were included. Grade III or higher HAIP-related postoperative complications were found in two patients (10%), both of whom had a reoperation (without laparotomy) to replace a pump with a slow flow rate or to reposition a flipped pump. No arterial bleeding, arterial dissection, arterial thrombosis, extrahepatic perfusion, pump pocket hematoma, or pump pocket infections were found within 90 days after surgery. After a median of 43 days (IQR 29–52) following surgery, all patients received the first dose of HAIP chemotherapy, which was completed uneventfully in all patients. Conclusion Pump implantation is safe, and administration of HAIP chemotherapy is feasible, in patients with resectable CRLMs, after training of a dedicated multidisciplinary team.

scholarly journals The impact of hepatic arterial infusion pump chemotherapy on hepatic recurrences and survival in patients with resected colorectal liver metastases

HPB ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. 1271-1279 ◽  
Author(s):  
Florian E. Buisman ◽  
Boris Galjart ◽  
Eric P. van der Stok ◽  
Nancy E. Kemeny ◽  
Vinod P. Balachandran ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
The Impact

scholarly journals Perioperative Hepatic Arterial Infusion Pump Chemotherapy Is Associated With Longer Survival After Resection of Colorectal Liver Metastases: A Propensity Score Analysis

2017 ◽  
Vol 35 (17) ◽  
pp. 1938-1944 ◽  
Author(s):  
Bas Groot Koerkamp ◽  
Eran Sadot ◽  
Nancy E. Kemeny ◽  
Mithat Gönen ◽  
Julie N. Leal ◽  
...  
Keyword(s):  
Propensity Score ◽  
Systemic Chemotherapy ◽  
Propensity Score Analysis ◽  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Complete Resection ◽  
Clinical Risk Score ◽  
Arterial Infusion ◽  
Node Negative ◽  
Score Analysis

Purpose To investigate whether perioperative hepatic arterial infusion pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM). Methods Patients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors. Results A total of 2,368 consecutive patients underwent a complete resection of CLM, with a median follow-up of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P < .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI ( P < .001). The hazard ratio adjusted by propensity score demonstrated longer OS with HAI: 0.67 (95% CI, 0.59 to 0.76; P < .001). A pronounced difference in median OS was found for patients with node-negative colorectal cancer (129 months with HAI v 51 months without; P < .001) and a low clinical risk score of 0 to 2 points (89 months with HAI v 53 months without; P < .001). Conclusion Patients who received HAI had a median OS of approximately 2 years longer than patients without HAI. The strong association was independent of the use of modern systemic chemotherapy and remained in propensity score analysis. Patients with node-negative primary tumors or a low clinical risk score seemed to benefit most from HAI.

Regional chemotherapy devices: effect of experience and anatomy on complications.

1993 ◽  
Vol 11 (5) ◽  
pp. 822-826 ◽  
Author(s):  
K A Campbell ◽  
R C Burns ◽  
J V Sitzmann ◽  
P A Lipsett ◽  
L B Grochow ◽  
...  
Keyword(s):  
Complication Rate ◽  
Hepatic Arterial Infusion ◽  
Regional Chemotherapy ◽  
Complication Rates ◽  
Arterial Infusion ◽  
Technical Complications ◽  
Surgeon Experience ◽  
Technical Complication ◽  
Arterial Anatomy

PURPOSE Regional hepatic arterial infusion (HAI) devices have been used for 17 years, but reports of unacceptably high complication rates have led to controversy about their use. Inadequate or misdirected infusion has been reported to occur in up to 45% of patients. We evaluated whether surgeon experience or presence of variant arterial anatomy related to risk of coagulation. MATERIALS AND METHODS We reviewed 70 patients undergoing placement of HAI catheters. Surgeons were classed as experienced after 10 procedures and arterial anatomy was evaluated angiographically with confirmation at operation. Complications were categorized as technical (17%) or chemotherapy-related (16%). RESULTS Inexperienced surgeons had a technical complication rate of 37% (80% of the patients involved had standard anatomy), while experienced surgeons had a technical complication rate of 7% (P < .01). Experienced surgeons had no complications in patients with standard anatomy, while inexperienced surgeons had a 42% (eight of 19) complication rate in similar patients (P < .01). CONCLUSION We conclude that technical complications are closely associated with surgeon experience and arterial anatomy.

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