Innovation of a Repeatable Microcatheter-accessible Port (ReMAP): Initial Clinical Results Evaluating Feasibility in the Treatment of Hepatocellular Carcinoma

Purpose: This study aimed to evaluate the feasibility of the Repeatable Microcatheter-accessible Port (ReMAP™) system in initial clinical experiences. Material and Methods: Eighteen patients with advanced hepatocellular carcinoma underwent ReMAP™ implantation. The 3.3-Fr catheter tip was positioned in the hepatic, gastroduodenal, or splenic artery, with the side hole located in the common or proper hepatic artery. The 6-Fr proximal end of the catheter was connected to the ReMAP™ device, implanted subcutaneously in the front thigh. A specialized 17-G cannulated needle was used to puncture the ReMAP™ system, allowing insertion of a microcatheter and guidewire, which exited via the side hole and were advanced into the targeted hepatic branches. Results: ReMAP™ implantation was successful in all cases. A total of 85 treatment sessions using microcatheters inserted via the ReMAP™ system were performed. All sessions successfully facilitated selective arterial infusion chemotherapy (75 sessions) and selective transarterial chemoembolization (10 sessions). During the treatment period (mean duration: 4.6 months), complications occurred in three cases (18%), including hepatic arterial occlusion, dislocation of the indwelling catheter, and biloma. Conclusions: Locoregional treatments using the ReMAP™ system are feasible for patients with advanced hepatocellular carcinoma.