浅側頭動脈動注術困難例の検討と二・三の対策

DIFFICULTY IN CATHETERIZATION OF THE SUPERFICIAL TEMPORAL ARTERY, AND ITS RESOLUTIONS

　I．はじめに

　頭頸部領域悪性腫瘍治療のために浅側頭動脈経由選択的局所動注療法が行なわれるようになつて来ているが，動注術施行時にチューブ挿入が困難な例を経験することがある。

　このようなチューブ挿入困難例に対しては，多くの場合，動注療法を断念しているのが実情ではなかろうか。

　This report is to help resolve those problems that encountered during catheterization of the superficial temporal artery for intra-arterial infusion therapy of malignant tumors of the head and neck. Difficulty in catheterization was mainly caused by the following factors; type of catheter, anatomical variation of the artery and technical problems of catheterization.

　As the conclusion, the following points were thought to be important that a catheter should be selected from either of Teflon or Irax, and the tip of the catheter should be rounded out, and that there were three different points were a catheter could not easily be introduced; 1-2 cm, 4 cm and 6-8 cm below the incised area of the artery, and thus the artery should be dissected and isolated as far enough as the posterior medial aspect of the mandibular joint. The small branches of the artery should be ligated or severed, and the bent area of the artery should be straightened. And in some instances, the artery should be dissected as much proximal as possible to the external carotid artery.

　The catheter could be easily inserted through the difficult points when it was rotated and advanced.