Limb perfusion

Limb perfusion is a medical procedure used to deliver high doses of chemotherapy directly to a specific area of the body, typically a limb, in order to treat cancerous tumors or metastases. This technique allows for a much higher concentration of chemotherapy drugs to be delivered to the affected area while minimizing the systemic side effects that can occur with traditional intravenous chemotherapy.

Procedure

During limb perfusion, a tourniquet is placed around the limb to restrict blood flow to and from the area being treated. A catheter is then inserted into a major artery supplying blood to the limb, such as the femoral artery in the leg or the brachial artery in the arm. Another catheter is inserted into a major vein to allow for the return of blood from the limb.

Once the catheters are in place, a high dose of chemotherapy drugs is infused directly into the arterial catheter, allowing the drugs to circulate within the limb and target the cancerous cells. The tourniquet prevents the drugs from circulating to the rest of the body, reducing the risk of systemic toxicity.

After a predetermined amount of time, the chemotherapy drugs are flushed out of the limb by perfusing the area with a neutralizing solution. The tourniquet is then released, allowing normal blood flow to resume in the limb.

Indications

Limb perfusion is commonly used to treat melanoma and sarcomas that have metastasized to the limb. It is particularly effective for tumors that are resistant to traditional forms of chemotherapy or for patients who are not candidates for surgery.

Complications

While limb perfusion is generally considered safe, there are potential risks and complications associated with the procedure. These can include damage to the blood vessels, nerve injury, infection, and compartment syndrome.

Follow-Up

Patients who undergo limb perfusion will require close monitoring following the procedure to assess for any complications and to evaluate the response to treatment. Additional treatments, such as radiation therapy or systemic chemotherapy, may be recommended depending on the individual case.