Annals of surgery · 2026
Technical Complications and Salvage of Hepatic Artery Infusion Pumps: An Institutional Experience of 2935 Consecutive Cases.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zaki Omar A, Schleimer Lauren E, Kalvin Hannah L, Choubey Ankur, Barekzai Ahmad B, Jung Joslyn, Armstrong Misha, Alessandris Remo, Rousian Merve, Geevarghese Ruben, Silliman Danielle, Gönen Mithat, Marinelli Brett S, Lidsky Michael E, Balachandran Vinod P, Drebin Jeffrey A, Saadat Lily V, Wei Alice C, Soares Kevin C, Kingham T Peter, Jarnagin William R, D'Angelica Michael I
Аннотация
OBJECTIVE: Describe the technical complications of hepatic artery infusion pump (HAIP) placement and characterize salvage rates.
SUMMARY BACKGROUND DATA: HAIP chemotherapy is an effective tool used in the treatment of hepatic malignancies and has become increasingly adopted at select centers. Much of the safety data is reported from small, newer programs or older, large series.
METHODS: Retrospective analysis of all patients who underwent HAIP placement at our institution between 2000 and 2022 was conducted. Pump salvage was defined as the ability to receive HAIP chemotherapy after a pump-associated complication. Pump failure was defined as an HAIP-related complication permanently stopping ongoing HAIP chemotherapy.
RESULTS: Over the study period, 2935 patients had an HAIP placed for colorectal liver metastases (n=2582, 88%), intrahepatic cholangiocarcinoma (n=294, 10%) or another malignancy (n=59, 2%). Of all patients, 759 (26%) had an HAIP-related complication, with 404/759 (53%) having their pump salvaged. The most common complications were abnormal perfusion (n=360 [12%], 285/360 [79%] salvaged), arterial pseudoaneurysm and/or hemorrhage (n=117 [4%], 7/117 [6%] salvaged), and pump-pocket infection (n=115 [4%], 60/115 [52%] salvaged). The complications with the highest salvage rates were pump-pocket seroma (n=15/16, 94%), pump-flipping (n=41/44, 93%), and pump-pocket hematoma (n=45/49, 92%). Unsalvaged complications were catheter dislodgement from vessel (n=0/47, 0%), catheter erosion into bowel (n=0/25, 0%), and arterial thrombosis (n=0/19, 0%). The cumulative incidence of pump failure at 1 year in patients receiving adjuvant therapy was 6.6%, and 4.5% among those receiving palliative therapy.
CONCLUSIONS: HAIP-related complications occur in about one quarter of patients, predominantly perfusion and pump-pocket complications. These are salvageable in the majority of cases with multidisciplinary interventions.
SUMMARY BACKGROUND DATA: HAIP chemotherapy is an effective tool used in the treatment of hepatic malignancies and has become increasingly adopted at select centers. Much of the safety data is reported from small, newer programs or older, large series.
METHODS: Retrospective analysis of all patients who underwent HAIP placement at our institution between 2000 and 2022 was conducted. Pump salvage was defined as the ability to receive HAIP chemotherapy after a pump-associated complication. Pump failure was defined as an HAIP-related complication permanently stopping ongoing HAIP chemotherapy.
RESULTS: Over the study period, 2935 patients had an HAIP placed for colorectal liver metastases (n=2582, 88%), intrahepatic cholangiocarcinoma (n=294, 10%) or another malignancy (n=59, 2%). Of all patients, 759 (26%) had an HAIP-related complication, with 404/759 (53%) having their pump salvaged. The most common complications were abnormal perfusion (n=360 [12%], 285/360 [79%] salvaged), arterial pseudoaneurysm and/or hemorrhage (n=117 [4%], 7/117 [6%] salvaged), and pump-pocket infection (n=115 [4%], 60/115 [52%] salvaged). The complications with the highest salvage rates were pump-pocket seroma (n=15/16, 94%), pump-flipping (n=41/44, 93%), and pump-pocket hematoma (n=45/49, 92%). Unsalvaged complications were catheter dislodgement from vessel (n=0/47, 0%), catheter erosion into bowel (n=0/25, 0%), and arterial thrombosis (n=0/19, 0%). The cumulative incidence of pump failure at 1 year in patients receiving adjuvant therapy was 6.6%, and 4.5% among those receiving palliative therapy.
CONCLUSIONS: HAIP-related complications occur in about one quarter of patients, predominantly perfusion and pump-pocket complications. These are salvageable in the majority of cases with multidisciplinary interventions.