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  • Superselective intra arterial chemotherapy for Retinoblastoma: 4 years experience

    Final Number:
    264

    Authors:
    Alejandro Ceciliano MD; Fernando Navarro MD; Andres Aguado MD; Adriana Fandi├▒o; Guillermo Chantada; Francisco Villasante MD

    Study Design:
    Other

    Subject Category:
    Basic Science

    Meeting: AANS/CNS Cerebrovascular Section 2015 Annual Meeting

    Introduction: Report our experience in superselective intra-arterial chemotherapy (SIAC) for advanced intraocular retinoblastoma and determinate if it is possible and safe to deliver the drug in the choroidal crescent.

    Methods: From 2010 to 2014, a total of 115 eyes of 89 patients with unilateral (n:63) and bilateral (n:26) advance intraocular retinoblastoma were treated. Mean age was 24 months (range 6-81, 55% women). We used direct OA micro-catheterization and if it was not possible or there was inadequate visualization of the choroidal crescent, alternative routes including the orbital branch of the MMA or the TSA were performed. The chemotherapies used were: melphalan, topotecan, and/or carboplatin. The main outcome measures were: procedural success and ocular and systemic complications.

    Results: There were 364 chemotherapy procedures. Delivering the drug in the choroidal ophthalmic blush was successful in 97,93% of procedures. Treatment routes included: 239 sessions of direct OA, 123 in MMA and only 2 TSA. Mean number of infusions was 3.8 per patient (range 1-14). Transient ocular complications were: 7 eyes with periocular edema, 3 eritema of the frontal skin and 2 third cranial nerve ipsilateral neuritis. Reversible extraocular occurrences were: 3 bronchospasms, 1 alergic reaction to iodinated contrast and 5 significant neutropenia. One permanent complication was observed: avascular retinopathy. All children are alive.

    Conclusions: Our experience demostrate that SIAC delivery in the choroidal crescent is possible and safe, even in complex anatomy and when direct OA catheterization was not an option.

    Patient Care: know different aspects in minimally invasive technique (low dose of chemotherapy and less x-ray dose)

    Learning Objectives: To improve the knowlegde in superlective cateterization of the ofthalmic artery

    References:

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