Abstract:

Background: article describes methodology of a selective ophtalmic arterieal infusion (SOAI) ir organ-preserving treatment of children with an intraocular retinoblastoma and demonstrates various ways of delivery of chemotherapeutic agent to a tumor.

Aim: was to increase efficacy of SOAI in treatment of children with intraocular retinoblastoma Material and methods: 289 SOAI procedures to 127 children (143 eyes) have been performed from 2013 to 2017. 2 methods of a SOAI were applied: 1) the microcatheter technique (n=223) - superselective catheterization of an eye artery or collateral branches of an external carotid artery (ECA) at blood flow hemodynamic redistribution; 2) the microballoon technique - balloon-occluder on ipsilateral internal carotid artery (ICA) for prevention of chemoinfusion of brain arteries (n=58). Results: technical success was 96,5%(279 procedures). From 223 procedures with using of a microcatheter infusion was carried out in: a. ophthalmica - 156(70%), a.meningea media - 44 (20%), a.infraorbitalis - 20(11%), a. temp. superficialis - 2, a.facialis - 1. From 58 procedures with using of microballoon - 56 were successful. We didn't manage to put a balloon more distally than the place of an entry of an eye artery in 2 cases. Unsuccessful attempts - 10 cases: failure of catheterization of a femoral artery - in 2, a kinking of the ICA - in 2, a vascular collapse as a result of reaction to injection of contrast agent and/or mechanical impact on ICA - in 2, lack of contrasting of a retina - in 3, an occlusion of an ICA - in 1.

Conclusion: possession and use of various techniques for chemotherapeutic agent delivery to an eye tumor allows to achieve the maximum effect and doesn't depend on anatomy options and blood flow hemodynamic redistribution in main vessels of an eye.

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Abstract:

The article makes an attempt to summarise variants of the PTBD that allows to change perceptions of this procedure as it is not a simple method as it seems in routine usage. A meaningful and reasonable use of PTBD combined with all modern technical possibilities in interventional radiology and professional personnel potential can significantly expand the scope of application for this technology and allows by using «small means» to deal with complicated clinical cases, optimizing the conditions for effective hi-tech medical support. Reducing PTBD options to the «common denominator» can optimize it's planning and accounting, can improve the quality and efficiency and can facilitate the clinical and scientific analysis of the results.

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