Technique for Placement of the Hepatic Arterial Infusion Pump

2003 ◽  
pp. 243-253
Keyword(s):  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion

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

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 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.

Hepatic arterial infusion (HAI) of oxaliplatin in advanced hepatocellular cancer (HCC): A phase I study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14010-14010
Author(s):  
R. Rathore ◽  
D. Iannitti ◽  
G. Soares ◽  
H. Wanebo ◽  
C. Maia-Aucna ◽  
...  
Keyword(s):  
Phase I ◽  
Phase I Study ◽  
Infusion Pump ◽  
Hepatocellular Cancer ◽  
Stage Iv ◽  
Hepatic Arterial Infusion ◽  
Duodenal Perforation ◽  
Arterial Infusion ◽  
Pump Therapy ◽  
Advanced Hcc

14010 Background: We performed this phase I study is to evaluate the feasibility and determine the Maximally Tolerated Dose of HAI-oxaliplatin given every 3 weeks in advanced HCC. Methods: Patients (pts) with unresectable or recurrent HCC were eligible for therapy on this protocol. HAI-oxaliplatin was administered over 2 hours via a percutaneously placed hepatic arterial catheter or a surgically inserted hepatic arterial infusion pump. Therapy was continued until disease progression or excessive toxicity not amenable to appropriate modifications. Restaging was performed after every 2 cycles. Dose escalation levels for HAI-oxaliplatin are 90 mg/m2, 110 mg/m2, 130 mg/m2 and 150 mg/m2 given every 3 weeks. Results: A total of 16 patients have been enrolled and toxicity data are available for all patients. Median age was 61 yrs (range 47–84 yrs), there were 15 men and 1 woman. The stage distribution is: stage II-3 pts, stage III- 7 pts, stage IV- 6 pts. Prior therapies including chemoembolization (CE) in 3 pts, radiofrequency ablation (RFA) in 3 pts, and both RFA and CE in 1 pt. A total of 37 cycles (range 1–3) have been delivered. Levels 1 and 3 had to be expanded to 6 pts each due to major toxicity in 2 pts at each level. Level 2 was expanded as 1 pt was non-compliant. Major toxicities are shown below. One patient developed embolic bowel ischemia after his HAI procedure. There was one episode each of duodenal perforation and duodenal ulceration. Traditional grade 3/4 hematologic and gastrointestinal toxicities were infrequent. Among 13 pts receiving at least 2 cycles, 3 pts had partial responses (PR) and 4 pts had stable disease (SD). Greater than 50% reduction in AFP was seen in the 3 pts with PR and 2 pts with SD. Conclusions: HAI-oxaliplatin is feasible, well tolerable, and demonstrates activity in this population of pts with advanced HCC. [Table: see text] No significant financial relationships to disclose.

Long-term hepatic arterial infusion of 5-fluorodeoxyuridine for liver metastases using an implantable infusion pump.

1983 ◽  
Vol 1 (5) ◽  
pp. 337-344 ◽  
Author(s):  
G R Weiss ◽  
M B Garnick ◽  
R T Osteen ◽  
G D Steele ◽  
R E Wilson ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Median Survival ◽  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Treated Group ◽  
Arterial Infusion ◽  
Median Response ◽  
Significant Difference ◽  
Pump Implantation

Twenty-one patients with liver metastases of various histologies (predominantly colorectal carcinoma) underwent Infusaid pump implantation for long-term hepatic arterial 5-fluorodeoxyuridine (5-FUdR) infusion. Patients received 5-FUdR infusion on a 2-wk cycle alternating with a 2-wk saline--heparin infusion. A dosage of 0.2-0.3 mg/kg/day (average 0.23 mg/kg/day) was infused for a cumulative 5-FUdR administration of 1940 days. Six patients (29%) responded to therapy (five colorectal, one carcinoid); median response duration was 6 mo. Median survival for the treated group was 17 mo from diagnosis of liver metastases and 13 mo from pump implantation. Median survival among the six responding patients was 15 mo from diagnosis of liver metastases and 11 mo from pump implantation. Comparison of survival from the diagnosis of liver metastases of the treated group to ten patients found ineligible for the study by virtue of extrahepatic metastases revealed no significant difference in median (18 mo for ineligible group) or overall survival. However, median survival for the treated group after pump implantation (13 mo) was significantly better than the median survival of the ineligible group after evaluation for this study (4 mo). Toxicities of therapy included fatigue, anorexia, nausea, vomiting, toxic hepatitis, epigastric pain, and diarrhea. No patients died of toxicity, but six patients required hospitalization for management of pain or vomiting. No serious technical complications developed in any patient except separation of the infusion catheter at its junction with the pump in one patient, necessitating pump replacement for continuation of therapy. These survival data suggest identification of new anticancer agents for hepatic arterial infusion.

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