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Cerebral infarction has been described as a serious complication that occurs in patients with HAIC catheters inserted via subcalavian and brachial routes [12]. Catheter redundancy in the aortic arch increases the risk of stroke in patients with subclavian catheters for HAIC infusion by increasing the formation of mural thrombus around the catheter [13]. Therefore, minimizing catheter redundancy in the aorta is important to reduce the frequency of cerebral infarction in patients when using these approaches. The increased risk of cerebral complications means that the brachial, axillary and subclavian arteries are not the access points of first choice.
The common femoral arterial approach is technically easier than the subclavian method as the vessel is superficial and less tortuous and remains the most popular vascular access route for the majority of endovascular procedures. In addition, this route obviates the risk of catheter-related stroke. Catheter migration due to the mobility of the hip joint initially made this access route less popular as patients were immobilized during the treatment period. With the increased use of catheter fixation techniques and the use of stiff copolymer fluorine–acryl–stryrene–urethane–silicone-coated catheters, however, this is no longer a major concern [14]. US and fluoroscopic guidance are used to puncture the femoral artery, and the right common femoral artery is often preferred.
Hepatic arterial infusion of chemotherapy: the role of diagnostic and interventional radiology
Annals of Oncology Volume 19, Issue 5 p. 847-851 2007
Dr R. Uberoi, Department of Radiology, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK.
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