A CASE OF RUPTURE OF THE RIGHT FEMORAL ARTERY DURING THE INDWELLING ARTERIAL INFUSION CATHETER THERAPY

Abstract

The indwelling arterial infusion catheter therapy has come the common use and offers excellent results, however some reports about complications are found. We report a case of rupture of the right femoral artery at a puncture site probably caused by the leakage of chemotherapeutic agents and infection. A 76-year-old man was given an indwelling arterial infusion catheter from the right femoral artery into common hepatic artery against multiple liver metastasis after sigmoidectomy. The reservoir was implanted subcutaneously at his right lower abdomen. He was administered 5-FU 300mg/day and leucovorin 30mg/day for 5 days into artery through this reservoir. At the initial administration of them, they leaked around the reservoir. The inguinal wound opened, MRSA infection arose and bleeding repeated three times. Enhanced CT and angiography showed a pseudoaneurysm at the right common femoral artery. The aneurysm wall consisted of connective tissue and the arterial wall defect was 18×8mm in diameter. After the debridement of necrotic and infected tissue and irrigation, the defect was closed with a saphenous vein patch. It is difficult to determine preoperatively the extension of arterial trauma caused by the leakage of chemotherapeutic agents and infection, and so we should keep in mind to use angioplasty or graft interposition.