PubMed · 13860010
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D ALANG. 1962. The aortoarteriogram.. https://pubmed.ncbi.nlm.nih.gov/13860010/
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PURPOSE: Isolated pelvic perfusion (IPP) therapy exposes target tissues to high doses of anticancer drugs with low systemic concentrations, but the major drawback is drug leakage into the systemic circulation, which often thwarts the increased drug concentration. In this study, the efficacy of altering the in-out flow rate during IPP in order to decrease the leakage was assessed in adult pigs. METHODS: The abdominal aorta and the infrarenal vena cava were occluded with two balloon catheters, blood in the extracorporeal circuit was circulated with twin rotary pumps, and the IPP was performed with platinum. Three sets of in-out flow rates were used, and the degree of drug leakage into the systemic circulation was evaluated. The volume of blood withdrawn was equal to the volume returned (300 ml/min; group A), 5% higher (group B), or 10% higher (group C). The platinum concentrations in the pelvic circulation, systemic circulation, and urine were measured and compared. RESULTS: The average and maximum plasma platinum concentrations in the pelvic circulation did not significantly differ among the three groups. The plasma platinum concentrations in the systemic venous circulation of the three groups significantly (P<0.01) decreased as the volume withdrawn during IPP increased. The percentage of platinum eliminated in the urine during IPP was significantly (P<0.01) lower in group B and C than in group A. CONCLUSIONS: Setting the volume withdrawn higher than the volume returned decreased leakage into the systemic circulation under isolated pelvic perfusion.
The mechanism of the antithrombotic effects of heparin and the synthetic antithrombin agent argatroban was evaluated in a dog model. Thrombus formation following balloon injury was evaluated by angioscopy in the right iliac arteries of 20 dogs to serve as a control. After the evaluation of the growth of thrombus on the control side, heparin (200 U/kg) or argatroban (0.2 mg/kg) was infused intravenously, and the distal site of the contralateral left iliac artery was injured in the same manner. At 30 to 120 min before the final examination, the proximal site of the left iliac artery also was injured. After antithrombotic drug infusion, the percent angioscopic stenosis at the distal site was much lower (P<0.0001) than that of the control site (mean stenosis index: 0.67 in heparin vs. 3.8 in control, and 0.25 in argatroban vs. 4.3 in control); however, thrombus formation was observed at the proximal site. With local delivery of a low dose of either antithrombotic drug (n=10), an antithrombotic effect was maintained until 4 h after the infusion. A very weak fluorescence of FITC-heparin was detected at the injured artery 2 h after infusion. In a shunt experiment involving 5 dogs, carotid arteries were injured and incubated in oxygenated Krebs--Henseleit solution before auto grafting into the femoral artery. At 2 h after the grafting, no thrombus was formed in the grafted vessels incubated for 4 h, but was formed in those incubated for 10 min. These results indicate that the relatively long antithrombotic effect of these drugs may be due to a local drug effect at the injured artery, as well as the recovery of the anti-thrombogenicity of the injured artery.
A 55-year-old woman developed an intractable right orbitofrontal headache. The symptoms subsided spontaneously 2 months after onset, but diplopia due to right abducens nerve palsy had occurred, and gradually worsened. Orbito-ocular signs were never observed throughout the clinical course. Brain MRI and MR angiography demonstrated abnormal signal changes corresponding to the right cavernous sinus. Angiography confirmed a dural carotid-cavernous sinus fistula (CCF) with three directional drainage routes in the arterial phase. Although the most prominent draining vein was the superior ophthalmic vein (SOV), an outflow with a high flow rate into the angular facial vein prevented prolonged enhancement of the SOV in the venous phase. These findings suggest that the absence of orbito-ocular signs in dural CCF with an anterior venous drainage could be attributed to the relief of venous hypertension of the SOV.