DIRECT HEMOPERFUSION UNDER INFRAHEPATIC INFERIOR VENA-CAVAL ISOLATIONFOR THE INTRAARTERIAL CHEMOTHERAPY OF PELVIC TUMORS

A new simple technique consisting of direct hemoperfusion under infrah epatic inferior vena caval isolation for intraarterial chemotherapy of pelvic tumors is herein described. The inferior vena cava is occluded at the infrahepatic level by means of balloon inflation using a ballo on-tipped catheter (16F), which is placed through the right greater sa phenous vein. The isolated infrahepatic vena caval blood is withdrawn by a centrifugal pump through a catheter (16F) in the contralateral gr eater saphenous vein and is filtered by direct hemoperfusion during in traarterial infusion of anticancer drugs. Venous reentry is provided b y the central lumen of the balloon-tipped catheter. This procedure was used sequentially on two different occasions to treat a patient with an extensive pelvic tumor. Good hemodynamic stability and a reduction of the systemic drug toxicities were confirmed in both trials. Therefo re, we believe that this technique is technically feasible and highly effective in reducing systemic toxicities during high-dose intraarteri al chemotherapy for pelvic tumors.