The Experience of Transarterial Infusion Therapy by Trans-axillary Arterial Approach for Metastatic Liver Tumor

We performed transarterial infusion therapy (TAI) for 12 metastatic liver tumor patients with implantation of the catheter by the axillary arterial approach. Two radiologists implanted the catheter from the left axillary artery by Seldinger's method directly, without sheath-introducer, into the proper hepatic artery. In succession, the surgeon implanted the reservoir into the subcutaneous pocket on the lateral border of the left major pectoral muscle. The patient was allowed free walking just after the operation with resting of the left arm for 1 day. There were no serious complications. The duration of the operation was 118.8 minutes including the time for hemostasis at the punctured artery, and the period of hospitalization was 10.3 days including the time for preoperative examination and postoperative infusion therapy. Eleven patients were evaluable for the direct effect on the metastatic liver tumor, and one showed CR, 4 showed PR, 3 showed NC and 3 showed PD, with a responce rate of 45%. The mean survival was 775.4 days for H1+H2 cases and 626.2 days for H3 cases. This method is thought to be useful for implantation of the catheter for TAI because of low invasiveness for the patients, short hospital stay for therapy and the necessity of only a few hands for the operation.