“Micro-introducer access” intra-arterial chemotherapy for retinoblastoma in an 8-week-old infant

Carlos M. Alvarez, Samir Sur, Brian M. Snelling, Robert M. Starke, Eric Peterson

Research output: Contribution to journalArticlepeer-review

Abstract

Intra-arterial chemotherapy (IAC) for retinoblastoma has emerged as a standard therapy to facilitate globe salvage in patients with retinoblastoma. However, transfemoral endovascular catheterization of the ophthalmic artery is typically reserved for infants aged 3 months or older due to size of the patient and vascular anatomy. Here, the authors report a successful case of transfemoral intra-arterial chemotherapy delivery performed for group E retinoblastoma in an infant at 8 weeks of age who weighed only 4.1 kg using “micro-introducer sheath” technique to minimize the size of the arteriotomy. The patient received Melphalan, Topotecan, and Carboplatin via infusion through a microcatheter placed in the right ophthalmic artery. The procedure was tolerated well, and the patient went on to have two additional IAC procedures. Follow-up examinations under anesthesia showed tumor regression in response to chemotherapy. While typically reserved for older and larger patients, with proper technical expertise, transfemoral intra-arterial chemotherapy can be considered in such small infants with highly advanced disease.

Original languageEnglish (US)
Pages (from-to)129-131
Number of pages3
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
Volume16
DOIs
StatePublished - Jun 2019

Keywords

  • Endovascular
  • Intra-arterial chemotherapy
  • Ophthalmic artery
  • Pediatrics
  • Retinoblastoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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