Percutaneous assisted venous return isolated limb perfusion

Area of Science:

• Oncology
• Vascular Surgery
• Medical Technology

Background:

• Isolated limb perfusion (ILP) delivers chemotherapy locally to minimize systemic side effects.
• Hyperthermic isolated limb perfusion (HILP) is common for sarcomas and melanoma but traditionally requires invasive open surgery.
• Current less invasive methods like isolated limb infusion (ILI) have suboptimal perfusion rates.

Purpose of the Study:

• To describe a novel, minimally invasive technique for performing HILP.
• To evaluate the efficacy and safety of this new approach compared to traditional methods.
• To reduce the morbidity associated with HILP procedures.

Main Methods:

• A minimally invasive technique using angiographically placed percutaneous cannulae with vacuum-assisted return for HILP.
• Utilized a standard extracorporeal circuit with an oxygenator/reservoir.
• Managed acid-base balance within the circuit.

Main Results:

• Achieved superior circulation of chemotherapeutic agents.
• Demonstrated significantly reduced morbidities compared to open surgical HILP.
• Enabled outpatient or limited-stay treatment possibilities.

Conclusions:

• The described minimally invasive HILP technique offers an effective and safer alternative to traditional open surgery.
• This approach enhances chemotherapy delivery while minimizing patient trauma and recovery time.
• Facilitates HILP as an outpatient or short-stay procedure, improving patient accessibility and reducing healthcare costs.