SUPRAOPHTHALMIC CHEMOTHERAPY WITH LONG TAPERED CATHETER - DISTRIBUTION EVALUATED WITH INTRAARTERIAL AND INTRAVENOUS TC-99M HMPAO

Supraophthalmic intraarterial chemotherapy has not become popular due to a high incidence of damage to the normal brain and eye. This damage is due to inhomogeneous distribution of the agent secondary to stream ing and other flow-related phenomena. To try to minimize this complica tion, the authors developed a catheter and studied different infusion techniques. A 4.5-F catheter tapered to 2.5 F was used to perform supr aophthalmic intraarterial chemotherapy in 26 patients with malignant g liomas. Forty-one of 45 catheterizations were successful. In 17 patien ts (20 procedures), technetium-99m hexamethyl-propyleneamine oxime (HM PAO) was then injected through the catheter and single photon emission computed tomography was performed to assess the cerebral distribution of the radiopharmaceutical with either a pulsatile or continuous infu sion technique. Diffuse and relatively homogeneous distribution of Tc- 99m HMPAO was observed with fast pulsatile infusion (10 of 10 procedur es); however, inhomogeneous distribution was mostly seen with slow con tinuous infusion (eight of 10 procedures).