Transarterial Infusion Chemotherapy/Embolization in the Pelvic Cavity Using a Steerable Microcatheter Alone Through the Outer Cannula of an 18G Needle (SMOC)

Abstract

Purpose: To report our initial experience with transarterial infusion chemotherapy/embolization (TAI/TAE) in the pelvic cavity using a steerable microcatheter alone through the outer cannula of an 18-gauge needle used as a sheath (SMOC) without a conventional diagnostic catheter and introducer sheath.Materials and Methods: From January to September 2017, the SMOC method was attempted in six consecutive patients (4 male, 2 female; median age, 79.5 years; range, 21-88 years) undergoing elective TAI/TAE in the pelvic cavity. TAI was performed with cisplatin and methotrexate for bladder cancer in four patients, while TAE was performed with gelatin sponge particles for chronic urethral bleeding after total cystectomy in one patient and for a retained placenta in one patient. The items evaluated were the performance of TAI/TAE procedure with the SMOC method, fluoroscopic time, manual compression time, post-procedural bed rest time, and complications.Results: Five of six patients (83%) successfully underwent the procedure with the SMOC method; in one patient with a severely tortuous iliac artery, we abandoned the SMOC method. The median fluoroscopic time in the five successful cases was 16 min (range, 7-33 min). The manual compression time was approximately 5 min in each case. The postoperative bed rest time was 5 h in the first three cases and 2 h in the subsequent two cases. No procedure-related complications, including arterial injury and hematoma formation, occurred in any patients.Conclusions: The SMOC method can be an alternative to the conventional method for TAI/TAE in the pelvic cavity.