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Isolated limb infusion with cytotoxic agents: A simplified approach for venous access
Author(s) -
Vyas Ajit,
Avritscher Rony,
Ensor Joe,
Ross Merrick,
Wallace Michael J.
Publication year - 2009
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/cncr.24736
Subject(s) - medicine , fluoroscopy , catheter , femoral vein , surgery , venous thrombosis , exact test , adverse effect , popliteal vein , vein , thrombosis , vascular access , anesthesia , hemodialysis
BACKGROUND: Isolated limb infusion (ILI) of cytotoxic agents is a regional therapy for cutaneous malignancies in a single extremity. Conventional ILI technique requires retrograde catheterization of the contralateral femoral vein. A novel modified ILI technique uses an ipsilateral popliteal venous approach. The purpose of this study was to compare the performance of ILI using the 2 different approaches. METHODS: Data from patients who underwent lower‐extremity ILI at the authors' institution between October 2005 and June 2008 were retrospectively reviewed. The authors compared the 2 ILI approaches with regard to overall procedure time, fluoroscopy time, and the number of callbacks to the operating room (OR) for flow‐related issues. The Student t test and Fisher exact test were used. Adverse events, including deep venous thrombosis (DVT) in the treated limb, were recorded. RESULTS: Between October 2005 and June 2008, 67 lower‐extremity ILI procedures (15 using a contralateral venous access approach and 52 using an ipsilateral venous access approach) were performed in 62 patients (28 men and 34 women aged 31‐82 years). The mean fluoroscopy times for the contralateral and ipsilateral groups were 17.9 and 8.3 minutes, respectively ( P = .0019). No significant difference in the overall procedure time and number of callbacks to the OR for flow‐related issues between the 2 groups was identified. CONCLUSIONS: The ipsilateral popliteal venous approach is a simplified and safe ILI technique with significantly lower overall fluoroscopy procedure times required for catheter placement and no difference in catheter‐related adverse events, when compared with the conventional contralateral approach. Cancer 2010. © 2010 American Cancer Society.