Abstract
An 85-year-old man was given a diagnosis of hepatocellular carcinoma. A reservoir port for hepatic arterial infusion (HAI) adjuvant chemotherapy was placed in the right brachial artery, and HAI chemotherapy was administered in June 2009. Redness and swelling with pain of the right arm developed, and the patient was admitted to our hospital with a diagnosis of infection at the site of the reservoir port in August 2009. After admission, bleeding from the right arm occurred frequently, and compression hemostasis was applied. However, the pulsatile tumor gradually increased in size, and a portion of the catheter because exposed. The reservoir port and the exposed catheter were removed. The pseudoaneurysm, 20 mm in diameter, was resected and end-to-end anastomosis of the right brachial artery was carried out. The postoperative course was uneventful, except for mild edema. The brachial artery became occluded due to long-term catheterization and ischemic changes in the forearm appeared due to the absence of major collateral pathways. However, reservoir port placement via the brachial artery is nevertheless considered to be acceptable because of the hygiene aspects of the placement and low incidence of complications, including psedoaneurysm.
