PARENCHYMAL DAMAGE IN THE TERRITORY OF THE ANTERIOR CHOROIDAL ARTERY FOLLOWING SUPRAOPHTHALMIC INTRACAROTID ADMINISTRATION OF CDDP FOR TREATMENT OF MALIGNANT GLIOMAS

We treated ten patients with malignant glioma by intracarotid chemothe rapy with cis-diamminedichloroplatinum (CDDP) and/or pyrimidinyl)methy l-1-(2-chloroethyl)-3-nitrosourea (ACNU). Three of the patients who un derwent supraophthalmic intracarotid infusion of CDDP developed a low- density area in the basal ganglia on CT scan or an enhancing lesion in the hypothalamic region on MRI, with or without neurologic symptoms. No patient had such complications with supraophthalmic infusions of AC NU, or with cervical intracarotid infusion of CDDP or selective infusi on of CDDP via the anterior or middle cerebral arteries. Supraophthalm ic intracarotid administration of CDDP may augment drug delivery to tu mors and prevent visual complications, but is accompanied by considera ble risk of parenchymal damage in the territory of the anterior choroi dal artery. Possible mechanisms for such complications are discussed.