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New devices and techniques
Original research
Catheterization complications of intra-arterial chemotherapy for retinoblastoma
  1. Craig Schreiber1,2,
  2. Gary Kocharian1,2,
  3. Natasha Kharas1,
  4. Jared Knopman1,2,
  5. Jasmine H Francis3,
  6. David H Abramson3,
  7. Y Pierre Gobin2
  1. 1Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
  2. 2Division of Interventional Neuroradiology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
  3. 3Department of Surgery, Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  1. Correspondence to Dr Craig Schreiber; cpq9005{at}med.cornell.edu

Abstract

Background Intra-arterial chemotherapy (IAC) is a growing method of therapy for retinoblastoma (Rb). There is an absence of data to support the safety of catheterization with intra-arterial infusion in this pediatric population

Objective To focus on the non-ocular catheter/procedural-related complications that our practice has experienced in order to lay a foundation for practices interested in performing these procedures and hopefully, to help prevent them from occurring.

Methods This is a retrospective review of the patient population with Rb treated in our center from May 2006 through May 2024. Every procedure performed was reviewed for non-ocular catheterization-related complications. This review included complications of access, the distal vessel (thrombosis, stenosis, and dissection), and non-ocular infarcts.

Results There were 2281 vascular access events, and 2681 distal catheterization procedures were performed for IAC infusion on 623 pediatric patients with Rb. Mean age of the population was 18.9 months. There were 31 complications directly related to catheterization: 7 (0.3%) related to femoral artery access and 24 (0.9%) were distal vessel injuries. Two (0.07% of total catheterizations) of the distal vessel injuries were asymptomatic cerebral infarcts diagnosed on follow-up MRI.

Conclusion Catheterization with IAC can be performed safely in this young pediatric population. There is a trend for fewer complications when using the smallest catheter system possible for procedures.

  • Angiography
  • Catheter
  • Complication
  • Pediatrics
  • Technique

Data availability statement

Data are available upon reasonable request. We have a database of all the patients with retinoblastoma that we treat with intra-arterial chemotherapy at our institution. This database was used for this retrospective review.

https://doi.org/10.1136/jnis-2024-022881

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    Data availability statement

    Data are available upon reasonable request. We have a database of all the patients with retinoblastoma that we treat with intra-arterial chemotherapy at our institution. This database was used for this retrospective review.

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    Footnotes

    • X @garykochar

    • Contributors All authors contributed extensively to this work. CS is the primary author and contributed to the data gathering, data analysis, writing, and editing of the manuscript. GK contributed to data gathering, writing, and editing of the manuscript. YPG is the senior author and guarantor of the data. He was involved in >99% of the procedures evaluated in this study, data gathering for all cases, writing, and editing/reviewing the manuscript. NK contributed extensively to the data analysis and formal statistical review, and the writing up of these statistics and results. JK was involved in some of the procedures evaluated in this study, and the writing/editing/reviewing of the manuscript. JHF and DHA contributed to the ophthalmologic oncologic care of all the patients in this study, and were involved in data gathering, and the writing/editing/reviewing of the manuscript.

    • Funding All funding for this research was provided independently through the Division of Interventional Neuroradiology at Weill Cornell Medicine.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.