Percutaneous Transvascular Retrieval of the Dislodged Port-A Catheter Using En Snare System via Femoral Vein Approach

經皮與股靜脈利用三環圈套器取出斷裂的門埠導管

黃培青(Pei-Ching Huang) ； 呂嘉偉(Kar-Wai Lui) ； 吳冠群(Koon-Kwan Ng) ； 吳樹鏗(Shu-Hang Ng) ； 萬永亮(Yung-Liang Wan)

《中華放射線醫學雜誌》 34卷3期 (2009/09) Pp. 145-152

摘要

評估經皮與股靜脈使用三環圈套器來取出斷裂的門埠導管其安全性與臨床功效。
在民國95年2月到97年12月期間，總共由25位病患身上藉由經皮血管內的方式取出26條斷裂的門埠導管；所有的介入性治療都是在放射線透視檢查下，經由右股靜脈置入的血管鞘、使用三環圈套器或合併使用豬尾導管來完成。其中20例介入性治療皆在門診進行；此26例介入性治療的特色都詳細記錄；統計方法使用Pearson相關係數與散佈圖來評估門埠導管植入期間長短、延遲取出的期間與取出手術時間的相關性。
此次研究中所有取出治療皆成功，成功率為百分之百。取出手術時間長短與門埠導管植入期間、延遲取出的期間無明顯相關性。所有病人對於取出手術都能容忍且沒有嚴重的併發症，除了其中一個病人在術後第一天感到傷口疼痛。
經血管取出斷裂的門埠導管是一安全、迅速且可靠的治療，可以避免開刀手術取出可能造成的危險；若病患的狀況穩定，此介入性治療可以在門診進行，不需住院。

並列摘要

To evaluate the safety and effectiveness of percutaneous transvascular retr ieval of the dislodged port-A catheter using En snare system via femoral vein approach.
From Feb. 2006 to Dec. 2008, percutaneous transvascular retrievals of 26 dislodged port-A catheters in 25 patients were done. All retrievals were performed with En snare system with or without pigtail catheters under fluoroscopic guidance through a 10 Fr. vascular sheath in right femoral vein. Twenty of total 26 procedures were performed on the outpatient basis. The characteristics of the 25 patients (26 retrieval procedures) were recorded. Pearson correlation and scatter plot were made to display the correlation between the retrieval procedure time, duration of implantation and delay retrieval, respectively.
Percutaneous retrievals of the dislodged port-A catheters were successful in all 26 procedures (100%). No significant correlation was statistically found between the retrieval procedure time, and both the duration of port-A catheter implantation and delay retrieval. Patients tolerated the procedures well and there was no major complication except wound pain in one patient on the day of the procedure.
Percutaneous transvascular retrieval of dislodged port-A catheter is a safe, rapid and reliable technique that can obviate the need for major surgical procedures. If the patient's condition is stable, it can be performed on the outpatient basis.