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ABSTRACT: Microcapsules, 106 micron (range, 50-350 micron), of different capsular materials (monoglyceride, monodiglyceride, natural wax, cellulose polymer, or lactic acid polymer) with and without floxuridine (2'-deoxy-5-fluorouridine, FUDR) were intraarterially injected into dog kidneys. The drug-release characteristics of the microcapsules, as determined by analysis of renal and systemic venous blood samples over a 6-hour period, were uniphasic or multiphasic depending on the capsular material. Histologic changes of varying degrees were noted in all kidneys embolized except for those subjected to capsules of the cellulose polymer. The most striking changes were produced by the lactide polymer capsules. The potential applications of microencapsuled chemotherapeutic agents in intraarterial transcatheter treatment of cancer are discussed.
Radiology 01/1987; 161(3):601-4. · 5.73 Impact Factor
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ABSTRACT: Intra-arterial chemotherapy of pelvic tumors may be complicated by coincident flow to the buttocks. Transcatheter occlusion of both the superior and inferior gluteal arteries may have a role in directing the flow of chemotherapeutic agents away from the buttocks and toward the true pelvis. The results of flow studies using technetium-99m-labeled macroaggregated human serum albumin were compared in 12 consecutive patients examined before and after transcatheter arterial occlusion, and the best results were obtained by selective occlusion of those arteries that demonstrated increased flow to the buttock on the initial study. Without the preselection of patients in whom the initial flow went mainly to the buttock, the results were inconsistent. Because of the increase in the procedure time and the occurrence of minor complications, such as local pain during or after the occlusion procedure, in all patients, proper patient selection is important.
Radiology 06/1985; 155(2):341-3. · 5.73 Impact Factor
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ABSTRACT: Arterial thrombolysis was successfully accomplished in 15 of 18 (83%) cancer patients by the continuous intraarterial transcatheter administration of streptokinase (70 units/kg/h or 5000 u/h and/or urokinase (400-500 u/kg/h) over 24-96 h. In 16 of these patients, the arterial thrombosis was a complication of transcatheter infusion of chemotherapeutic agents or embolization therapy. A combination of streptokinase, urokinase and heparin (10,000-25,000 U/day) was utilized without significant side effect and was effective in all 8 patients receiving treatment. Creating a tunnel through the clot, daily monitoring of the catheter with repositioning when necessary, and adjusting the type and dose of thrombolytic agent aided the therapeutic management.
CardioVascular and Interventional Radiology 02/1985; 8(1):1-7. · 2.09 Impact Factor
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ABSTRACT: Transcatheter intra-arterial therapy for the cancer patient encompasses infusion of chemotherapy and embolization. Intra-arterial infusion of chemotherapeutic agents has been resurrected because of the availability of new drugs, combinations of drugs, and the capability of percutaneous selective catheter placement. Intra-arterial infusion has been effective in patients with carcinomas of the liver, bladder, prostate, uterus, ovary, and lung and in bone and soft tissue sarcomas, melanomas, and tumors of the brain. Embolization of the arterial supply, creating ischemia of the neoplasm, has been employed in the therapeutic management of patients with primary and secondary neoplasms of the liver, kidney, and bone. The median survival of 100 patients with neoplasms of the liver from the time of hepatic artery embolization was 11.5 months. In 100 patients with pulmonary metastases from carcinoma of the kidney, 28 experienced a response to renal artery embolization, a therapeutic delay of 4 to 7 days, nephrectomy, and Depo-Provera (medroxyprogesterone). Seven of 12 patients with giant cell tumor of the pelvis and lumbar spine responded to arterial embolization after all other therapy failed. Chemoembolization, the combination of arterial infusion of chemotherapy and embolization, can be accomplished by the use of microencapsulated agents, liposomes, and particulate emboli with drugs. This approach integrates the advantages of infusion and occlusion, and has considerable potential. Intra-arterial immunotherapy has been initiated with bacillus Calmette-Guerin (BCG) administration into renal neoplasms in patients with metastatic disease.
Cancer 01/1985; 54(11 Suppl):2751-65. · 4.77 Impact Factor
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ABSTRACT: Intraarterial occlusion-infusion of vincristine and Adriamycin was performed in six dogs using balloon infusion catheters. Tissue toxicity was compared with that obtained when the same drugs were administered by simple arterial infusion. Balloon occlusion of the external iliac artery produced reversed blood flow in the deep femoral, caudal femoral, and superficial circumflex iliac arteries, potentially altering the distribution of the drugs. Thrombosis of arterial branches occurred in three dogs, sooner but no more often in the groups receiving occlusion-infusion chemotherapy. Skin ulceration and dilatation of peripheral small vessels were significantly more frequent and extensive in the groups receiving occlusion-infusion. One infusion dog developed a single small ulcer on the hind paw; five of the six occlusion-infusion dogs developed multiple skin ulcers on the thigh and/or distal extremity. These findings suggest that even though intraarterial occlusion-infusion chemotherapy is not applicable in all instances, the technique does produce significantly greater drug-related effects than simple intraarterial infusion.
American Journal of Roentgenology 12/1984; 143(5):1069-73. · 2.78 Impact Factor
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Current Problems in Cancer 12/1984; 8(17):1-62. · 1.33 Impact Factor
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ABSTRACT: Reflecting on the studies by O'Riordan et al. and Doppman and Girton that are reported in this issue, the authors discuss the safety of using ethanol for hepatic artery embolization (HAE) and stress that the optimal indications for this procedure are still to be established. They indicate that the caution necessary with any technique can direct rather than inhibit action.
Radiology 10/1984; 152(3):821-2. · 5.73 Impact Factor
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ABSTRACT: The authors review the anatomy of the middle sacral artery and its relationship to the lower lumbar and internal iliac arteries. Middle sacral arteriography was performed in 8 patients, transcatheter tumor embolization in 6, and infusion chemotherapy in 1. There were no complications. The authors consider selective middle sacral arteriography beneficial in the diagnosis and treatment of sacral tumors.
Radiology 05/1984; 151(1):65-7. · 5.73 Impact Factor
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ABSTRACT: The translumbar approach was used for renal angiography and transcatheter embolization in a patient whose usual sites of vascular entry were not available because of arteriosclerotic occlusive vascular disease. A description is given of the reasons for embolization and the method used.
CardioVascular and Interventional Radiology 02/1984; 7(5):232-3. · 2.09 Impact Factor
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ABSTRACT: Six adult mongrel dogs received bilateral sequential renal arterial injections of degradable starch microspheres following preadministration arteriograms. Renal arterial flow was measured using electromagnetic flow probes, and microspheres were administered until flow was blocked completely. One kidney in each dog was subjected to immediate postembolization arteriography, while the contralateral kidney served as a control. In the control kidneys, arterial flow returned to 90-95% of baseline within 30 minutes of embolization, and angiography at this time revealed a normal nephrogram. Blood flow in the kidneys that received postembolization arteriography returned to only 60-65% of baseline, even when followed up to 1 hour. Angiography at this time revealed persistent defects in the nephrogram. The effect of heparin, Renografin-60, and distilled deionized water on amylase activity was evaluated in vitro. No change in enzyme activity was noted.
Investigative Radiology 19(2):119-22. · 4.59 Impact Factor
