Problems of Continuous Chemotherapy by Arterial Catheters

Abstract

Introduction Intra-arterial administration of chemotherapeutic agents is used by an increasing number of investigators as a means of obtaining a higher drug concentration in the tumor than in the remainder of the body. In contrast to the alkylating agents, antimetabolites have to be given over a period of at least several days in order to be effective. Sullivan first demonstrated, in 1958, that such treatment with methotrexate can be successful but that for optimal results 2 to 3 adequate courses of treatment are the minimum requirement. This implies that the intra-arterial catheter has to function properly for at least 6 weeks if not longer. In a report on 76 patients undergoing treatment through intra-arterial catheters, Duff et al. already noted complications such as bleeding, infection, or leakage, jeopardizing in a few cases even 1 adequate course of treatment. The nature of these complications suggested that they might arise more frequently