Neurologic complications of pelvic intraarterial chemoembolization performed with collagen material and cisplatin

In three patients neurologic complications developed after chemoembolization procedures were performed with cisplatin and a new collagen material. Three patients with dominant unilateral stage III cervical carcinoma were entered into an investigative protocol attempting to control regional disease and pain with chemoembolization. All three patients had previously undergone surgery, radiation therapy, and intraarterial chemoembolization or chemoinfusion. Each case was complicated by neurologic deficits. A collagen material was administered that acts at a precapillary level and reduces the likelihood of collateral flow. The size of the material enables it to embolize the small feeding vessels of the spinal cord and peripheral nerves. The patients in this study also had predisposing factors to neurologic sequelae including the previous therapy and the contributing neurotoxicity of cisplatin. The neurologic complications in these patients are not easily explained by knowledge of the neurovascular anatomy. Even with meticulous technique, intraarterial chemoembolization of the pelvis with cisplatin and collagen can be complicated by serious neurologic deficits.