Premium
Pulsed arterial infusions. Chemotherapeutic implications
Author(s) -
Wright Kenneth C.,
Wallace Siney,
Kim E. Edmund,
Hynie Thomas,
Charnsagavej Chulsip,
Carrasco C. Humberto,
Chuang Vincent P.,
Gianturco Cesare
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860515)57:10<1952::aid-cncr2820571011>3.0.co;2-s
Subject(s) - medicine , catheter , arterial catheter , homogeneous , chemotherapy , arterial blood , anesthesia , nuclear medicine , surgery , physics , thermodynamics
To simulate the intra‐arterial infusion of chemotherapy, ink was infused at a steady rate through a vascular catheter inserted in a transparent tube carrying water at a rate similar to that of arterial blood. The ink ran in one or two discrete streams for 10 to 15 cm before mixing with the water, and there were substantial differences in the concentrations of ink in the water collected from side holes made at various distances from the catheter tip. If the ink was delivered in short pulses, however, it mixed with the water 2 to 3 cm beyond the catheter tip, and the samples collected from the side holes showed similar concentrations of ink. A similar situation may be encountered when chemotherapeutic agents are infused into patients. Therefore, pulsation may produce a more homogeneous drug distribution in the infused tissue. The in vitro data was substantiated in patients by the following: (1) the intra‐arterial administration of technetium 99m( 99M Tc)labeled macroaggregated albumin (MAA) by both steady and pulsed infusions; and (2) changes in the severity of inflammatory skin reactions frequently associated with intra‐arterial chemotherapy of the extremities. Improved isotope distribution was noted in 19.3% of the liver and 40% of the extremity studies. Reduced skin reactions were observed in approximately 90% of the extremities receiving pulsed chemotherapeutic infusions.