Trapezius Port Placement in Patients with Breast Cancer: Long-Term Follow-up and Quality-of-Life Assessment.

PURPOSE: To evaluate the long-term results of and patient satisfaction with trapezius ports in breast cancer patients, as an alternative to chest ports. PATIENTS AND METHODS: This retrospective study included all patients who underwent trapezius port placement from December 2007 to January 2017. Seventy female patients with breast cancer, with a mean age of 54 ± 9.9 years (range, 29-76 years), were included. Indications for trapezius implantation were bilateral breast surgery or unilateral breast surgery and contralateral breast involvement. Sixty-eight of 70 patients had long-term follow-up. A retrospective, questionnaire-based survey was conducted to assess satisfaction and the trapezius port's effect on the daily life of the patient. RESULTS: All implantations were technically successful. Total catheter service time for 68 patients was 65,952 days (2 patients were lost to follow-up). Mean catheter service time was 969.8 days (range 7-3,458 days; median 570 days; 95% confidence interval, 739-1199; standard deviation, 947.7). No immediate procedural complications occurred. Port complications developed in 4 patients (5.9%); port infection developed in 2 patients (0.03/1,000 days); skin dehiscence developed in 1 patient (0.02/1,000 days); and port malfunction developed in 1 patient (0.02/1,000 days). The overall infection rate was 2.9% (2/68). All patients (n = 44) or a close relative (n = 17) who were interviewed with a phone call reported satisfaction regarding their ports. CONCLUSIONS: Trapezius ports offer a safe and feasible option to patients with breast cancer who need an alternative site to chest ports. It is also associated with high overall patient satisfaction.

Transarterial chemoembolization for treatment of hepatocellular carcinoma: A single center experience.

BACKGROUND/AIMS: We aimed to determine the effect of transarterial chemoembolization treatment on survival in patients with hepatocellular carcinoma and to investigate the efficacy and tolerability of two different transarterial chemoembolization procedures, conventional transarterial chemoembolization and drug-eluting beads, in these patients. MATERIALS AND METHODS: A total of 40 patients with hepatocellular carcinoma treated with transarterial chemoembolization between January 2007 and March 2011 were included. Thirty-seven patients had Child-Pugh class A and the remaining 3 had class B. Intra-arterial administration of doxorubicin with lipiodol-based conventional transarterial chemoembolization or drug-eluting beads-transarterial chemoembolization was performed. Eighty sessions were performed with a median of 2 sessions. Sixteen patients were treated with conventional transarterial chemoembolization and 11 with drug-eluting beads-based transarterial chemoembolization, and 13 were treated with both treatment procedures in separate sessions. Primary outcome was defined as patient survival after treatment. RESULTS: The median follow-up was 19 months. The median overall survival of patients was 23.2 months. The survival of patients with Child-Pugh class A was significantly better than that of patients with class B (24 vs 6 months, p=0.004). No statistically significant difference in survival was observed between conventional transarterial chemoembolization and drug-eluting beads-based transarterial chemoembolization treatments (p>0.05). Baseline low serum albumin level (p=0.003) and the presence of portal vein thrombosis (p=0.011) negatively affected patient survival. Side effects of conventional transarterial chemoembolization and drug-eluting beads-based transarterial chemoembolization were similar. CONCLUSIONS: Based on the results of this study and in comparison with the findings in the literature, transarterial chemoembolization treatment was seen to improve overall survival and provide better outcome in selected patients with hepatocellular carcinoma. No differences in survival or side effects were observed between the two transarterial chemoembolization treatment modalities.

Selective intraarterial nimodipine treatment in an experimental subarachnoid hemorrhage model.

BACKGROUND AND PURPOSE: Cerebral vasospasm secondary to subarachnoid hemorrhage (SAH) has been a serious clinical problem. The aim of the present study is to evaluate the efficacy of selective intraarterial (IA) nimodipine treatment in a rabbit model of chronic cerebral vasospasm. METHODS: Twenty-two adult New-Zealand rabbits of either sex, weighing 2500-3800 g were used for this study. Following a control angiography, all animals received 1 mL of fresh unheparinized autologuous arterial blood into the cisterna magna. Three days later, the presence of vasospasm was demonstrated angiographically by selective vertebral artery injection. The experimental design was as follows: separate groups of animals (n = 5, in each group) received nimodipine (0.05 mg/kg), papaverine (6 mg/kg), or vehicle intraarterially, after placement of a microcatheter into the vertebral artery. Another group (n = 5) received nimodipine (0.05 mg/kg) directly into the cisterna magna, and vehicle injection was made into cisterna magna in two other animals. Thirty minutes after treatment, angiographies were repeated and changes in arterial diameter were expressed as percentages of control. RESULTS: IA nimodipine and IA papaverine were effective in relieving veretebral and basilary vasospasm (P < .05). IA nimodipine was more effective than IA papaverine (P < .05). IA nimodipine was not more effective than intrathecal (IT) nimodipine in relieving vertebral artery vasospasm, although it was more effective than IT nimodipine in basilar artery. Vehicle injections (IA or IT) failed to reverse the vasospasm induced by autologuous blood injection. CONCLUSION: This study showed that selective IA nimodipine treatment may be considered as an alternative in the treatment of chronic vasospasm following SAH.