minimally-invasive-isolated-limb-perfusion-mi-ilp-for-locally

Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity

Minimally invasive isolated limb perfusion (MI-ILP) is a treatment option for patients with locally advanced melanomas and sarcomas of the extremities. ...

Sahlgrenska University Hospital

Isolated limb perfusion (ILP) and isolated limb infusion (ILI) are treatment options for patients with locally advanced melanomas and sarcomas of the extremities. ILP potentially have higher response rates, but requires open surgery for vascular access, whereas ILI is minimally invasive and easier to perform. We now present the technical details and outcome of a new approach to ILP by a minimally invasive vascular access (MI-ILP).

Minimally invasive isolated limb perfusion - technical details and initial outcome of a new treatment method for limb malignancies.

Isolated limb perfusion (ILP) is used for melanoma in-transit metastases of the extremities. The use of Melphalan and TNF-alpha, necessitates monitoring of possible systemic leakage throughout the perfusion. It has been suspected that leakage through bone marrow is possible. We present the case of a patient with in-transit melanoma metastases in the lower extremity, who underwent minimally invasive ILP, according to our new protocol through percutaneous insertion of the catheters under fluoroscopy. Following cannulation of the vessels a high leakage rate was recorded. The procedure was converted to open with clamping of the artery and vein, however the leakage was not possible to control, and venography showed that this was due to bone marrow veins. To the best of our knowledge this is the first case of a verified leakage during ILP through bone marrow veins. We believe that some minor leakages registered under ILP could be attributed to this leakage route.

Article	Year
Minimally invasive isolated limb perfusion - technical details and initial outcome of a new treatment method for limb malignancies. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group\| PubMed ID: 30428725	2018
Leakage through the bone-marrow during isolated limb perfusion in the lower extremity. Journal of surgical case reports\| PubMed ID: 30967928	2019

Per Carlson

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