Pressure-suit combined with pelvic stop-flow: a feasibility study in a bovine model

Area of Science:

• Oncology
• Surgical Innovation
• Pharmacokinetics

Background:

• Isolated pelvic perfusion offers high local drug delivery for advanced pelvic cancers.
• Leakage of perfusate into systemic circulation limits this technique's efficacy.
• Developing methods to minimize systemic leakage is crucial for optimizing perfusion therapy.

Purpose of the Study:

• To enhance the perfusion ratio between local and systemic compartments during isolated pelvic perfusion.
• To investigate the efficacy of an inflated pressure-suit in reducing systemic leakage in a bovine model.
• To test the hypothesis that external pressure above stop-flow points can decrease regional-to-systemic blood flow.

Main Methods:

• A pressure-suit was adapted and applied to 6 bovine subjects, chosen for their size compatibility.
• The pressure-suit was inflated to two pressure levels (40mmHg and 125mmHg) above aortic and caval stop-flow sites.
• Cisplatin pharmacokinetic studies were conducted to quantify drug distribution in both locoregional and systemic compartments.

Main Results:

• The locoregional to systemic drug concentration ratio at 30 minutes was 4 with 40mmHg and 9.7 with 125mmHg pressure-suit inflation.
• Pelvic to systemic exposure ratios at 30 minutes were 5.9 (40mmHg) and 14.9 (125mmHg).
• Leakage was significantly reduced at higher pressure-suit inflation (7% at 125mmHg vs. 18% at 40mmHg).

Conclusions:

• The use of an inflated pressure-suit effectively increased the perfusion ratio in isolated pelvic perfusion.
• This method demonstrates a significant reduction in systemic leakage compared to standard perfusion techniques.
• The findings support the potential of pressure-suit technology to improve the safety and efficacy of isolated pelvic perfusion for cancer treatment.