Vascular complications of total abdominal perfusion and aortic stop-flow infusion

Ehud S. Klein*, Gur Y. Ben-Ari, Moshe Z. Papa, Raphael Adar, Arie Bass

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

During a 2 year period (1992-1993), 149 patients with advanced abdominal cancer underwent total abdominal ischemic perfusion (TAP) and stopflow infusion (SFI) 159 times in an attempt to achieve palliation. These procedures and aortic stop-flow infusion require insertion of balloon catheters into the abdominal aorta and inferior vena cava by a transfemoral approach. Flow is arrested for 15 minutes, during which time chemotherapeutic agents are infused into the aorta, distal to the balloon occlusion. Femoral access is by a surgical incision. The passage of the catheters is guided by fluoroscopy. Some tumor response was observed in 35% of the patients. Ten patients had major vascular complications; two iliac artery aneurysms were lacerated and required emergency repair. There were two femoral artery false aneurysms that required surgical correction, one early and one late. Aortic dissection was detected in four patients, but these did not require surgical intervention. Two patients had thrombosis distal to the occluded vessel, both required surgical intervention. To reduce the incidence of these vascular complications we recommend: (1) a clinical and vascular laboratory evaluation before the procedure, and (2) angiography of normal flow in patients with underlying vascular disease.

Original languageEnglish
Pages (from-to)17-19
Number of pages3
JournalJournal of Surgical Oncology
Volume61
Issue number1
DOIs
StatePublished - Jan 1996

Keywords

  • regional cancer chemotherapy
  • total abdominal perfusion
  • vascular complications

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