VASCULAR COMPLICATIONS OF ISOLATED LIMB PERFUSION

Aim: Isolated limb perfusion (ILP) is a complex vascular procedure whi ch uses an extracorporeal circuit with high doses of cytostatic drugs and often hyperthermia for the treatment of extremity tumours. Our stu dy investigated the incidence, treatment and subsequent outcome of vas cular complications after ILP, about which little is known. Methods: A retrospective study was performed, in which we found 10 vascular comp lications after 466 ILPs (2.1%). Results: In eight patients, acute art erial obstruction developed in the immediate post-operative period, re sulting from a thrombus at the arteriotomy site. Prompt reintervention with thrombectomy restored the circulation in all patients. One patie nt developed an arterial thrombus in the brachial artery due to compre ssion of the surrounding tumour 12 days after ILP, which was successfu lly treated with thrombectomy and freeing the artery from the tumour. One patient was treated conservatively for digital micro-emboli. All c omplications occurred in women, maybe because of their generally small er vessel size. No limbs were lost and all patients were free of any v ascular problem after a median follow-up of 3.6 years. Conclusions: We conclude that vascular complications after ILP are rare, consist main ly of thrombosis at the arteriotomy site and can be successfully treat ed by prompt thrombectomy. Therefore, close observation of the periphe ral circulation after ILP is necessary.