Isolated limb infusion for local control of lower limb melanoma: Radiologic aspects

Abstract

To describe the technical radiological aspects of isolated limb infusion (ILI) to assist those procedural radiologists who carry out ILI on an occasional only basis and to inform the Australian radiologist community about this deserving but relatively little known radiological procedure. Retrospective audit of radiological catheter placement for 23 lower limb ILI procedures carried out for 16 patients with locally recurrent melanoma over 2 years (January 2002 to December 2003). Arterial and venous catheter placement, although sometimes difficult, was successful in all but four occasions. Unfavourable vascular anatomy was the main reason for failure. If approached systematically and with the knowledge of the patient's vascular anatomy, the outcome will be satisfactory in the hands of the generalist. Knowing the common technical pitfalls will certainly assist. Isolated limb infusion deserves to be more widely known in the radiological and surgical communities.

Ab initio RAFT emulsion polymerization of butadiene using the amphiphilic poly(acrylic acid‐b‐styrene) trithiocarbonate as both surfactant and mediator

“…One risk of using the ipsilateral venous access approach is the potential for postoperative DVT related to the indwelling catheter or the trauma of the popliteal vein at the access site. Venous thromboembolism cannot only lead to pulmonary emboli but can also cause significant chronic venous disease, increasing the morbidity of patients already in poor condition 18, 19. Although our sample sizes were relatively small, we did not find a significant difference between the contralateral and ipsilateral venous approach with regard to DVT.…”

Isolated limb infusion with cytotoxic agents: A simplified approach for venous access

“…Venous thromboembolism cannot only lead to pulmonary emboli but can also cause significant chronic venous disease, increasing the morbidity of patients already in poor condition. 18,19 Although our sample sizes were relatively small, we did not find a significant difference between the contralateral and ipsilateral venous approach with regard to DVT. There were no cases of DVT in the treatment limb in the ipsilateral group, and, thus, this approach from a catheter-related complication standpoint is as safe as the contralateral approach.…”

Isolated limb infusion: Technical aspects

“…The catheters are inserted in the radiology department on the morning of the ILI procedure. Small caliber catheters are used, inserted percutaneously using a standard Seldinger technique via the common femoral artery and vein in the contralateral groin after systemic heparinization using 5,000–10,000 U . The venous catheter of choice is a straight 8FG catheter with 10 side holes near its tip (William A. Cook Pty.…”