title: Intra-arterial chemotherapy for bilateral retinoblastoma via left ophthalmic artery and right anterior deep temporal artery.
abstract: A 12-month-old boy with a history of bilateral retinoblastoma refractory to systemic chemotherapy, laser therapy and cryotherapy, with excellent response to previous intra-arterial melphalan infusion, presents with active tumour deposits in the right eye. Repeat intra-arterial chemotherapy was recommended. Previous bilateral melphalan infusion was uneventful using flow-guided catheterisation technique. Direct catheterisation of the right ophthalmic artery was unsuccessful despite employment of several flow-guided and over-the-wire catheters. Superselective catheterisation of the ipsilateral middle meningeal artery was unable to identify an anastomotic connection to the ophthalmic artery; however, angiography of the anterior deep temporal artery identified an alternate route for chemotherapy infusion. The anterior deep temporal artery was successfully and safely catheterised to infuse chemotherapy into the ophthalmic artery. The anterior deep temporal artery is an important potential anastomotic connection to the ophthalmic artery that can be used safely and effectively for central retinal artery chemotherapy infusion for retinoblastoma treatment.
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Amans
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.
authors.forename: Jared
authors.initials: J
authors.lastname: Narvid
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.
authors.forename: Van V
authors.initials: VV
authors.lastname: Halbach
mesh_terms: D000792:Angiography; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D002404:Catheterization; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D009880:Ophthalmic Artery; D012160:Retina / Q000473:pathology; D019572:Retinal Neoplasms / Q000188:drug therapy*; D012175:Retinoblastoma / Q000188:drug therapy*; D013699:Temporal Arteries
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan