Surgery · Oncology · 2 h ago
HAI pump complications occurred in 26% of patients in a 22-year series
A retrospective single-center study of 2,935 patients who received hepatic artery infusion pumps from 2000 to 2022 assessed technical complications and pump salvage. Complications occurred in 26%; just over half of affected pumps were salvaged, with outcomes varying substantially by complication type.
- Complications affected 26% of 2,935 HAIP recipients.
- Overall, 53% of complicated pumps were salvaged.
- Salvage varied sharply by complication type.
- One-year pump failure was under 7% in both treatment groups.
Researchers retrospectively reviewed all hepatic artery infusion pump (HAIP) placements at one institution between 2000 and 2022. The 2,935 patients primarily had colorectal liver metastases (88%); 10% had intrahepatic cholangiocarcinoma, and 2% had other malignancies. Pump salvage was defined as resuming HAIP chemotherapy after a pump-related complication; pump failure meant the complication permanently stopped ongoing treatment.
A total of 759 patients (26%) had a HAIP-related complication, and 404 of these pumps (53%) were salvaged. Abnormal perfusion was the most common complication (360 patients; 79% salvaged). Salvage was less frequent after arterial pseudoaneurysm or hemorrhage (7 of 117; 6%) and occurred in 60 of 115 pump-pocket infections (52%). Catheter dislodgement, catheter erosion into bowel and arterial thrombosis were not salvaged in this series. One-year cumulative pump failure was 6.6% among patients receiving adjuvant therapy and 4.5% among those receiving palliative therapy.
The findings quantify complication and salvage outcomes in a large, long-running institutional experience and may inform discussions about HAIP treatment and its technical risks. Results are retrospective and from a single institution; salvage rates may depend on local expertise and multidisciplinary management, limiting generalizability.
In practice
For clinicians discussing hepatic artery infusion pump chemotherapy with patients who have hepatic malignancies, this single-center series provides estimates of technical complications and the likelihood that treatment can continue afterward. Complications occurred in about one quarter of recipients, and 53% of affected pumps were salvaged; prospects differed markedly by complication, with arterial thrombosis and certain catheter complications not salvaged in this cohort. These retrospective institutional results may not generalize to centers with different experience or management practices and do not establish which interventions improve salvage.
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Annals of Surgery: Technical Complications and Salvage of Hepatic Artery Infusion Pumps ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.