Intra-arterial drug delivery: a concise review.
The therapeutic potential of intra-arterial (IA) drug delivery to the brain has received limited attention in the last decade. In the 1980s, efforts to treat brain tumors with IA chemotherapy, the leading application of this technology, yielded modest results. Poor control of tissue drug concentrations and the potential risk of permanent neurologic injury further prevented the wider use of IA drugs. Yet, IA drugs were anecdotally used for treating a wide spectrum of brain diseases. Recent advances in endovascular technology and the increased safety of angiographic procedures now compel us to reevaluate IA drug delivery. This review describes the pharmacologic principles, applications, and pitfalls of IA drug delivery to the brain.
Joshi
Shailendra
S
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA. sj121@columbia.edu
Emala
Charles W
CW
Pile-Spellman
John
J
D000777:Anesthetics / Q000008:administration & dosage; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001931:Brain Mapping; D002494:Central Nervous System Infections / Q000188:drug therapy; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015316:Genetic Therapy; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects; D019586:Intracranial Hypertension / Q000188:drug therapy; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000188:drug therapy
D000777:Anesthetics; D000970:Antineoplastic Agents; D005343:Fibrinolytic Agents; D004364:Pharmaceutical Preparations; D014665:Vasodilator Agents