Vascular diversion in chemotherapy of brain tumors

Of the patients with malignant gliomas treated by arterial infusion of chemotherapeutic agents at one institution, tumor extension beyond the territory supplied by a single internal carotid artery was documented at operation or by computed tomography or angiography in 55%. In 47% of the patients, a surgical procedure was performed to modify the cerebral circulation so that the entire lesion could be treated by infusing a single internal carotid artery. This report examines the anatomical and radiological background for these procedures, and the surgical options, techniques, and complications in this series of patients.