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Tumor embolization
Original research
Incidence and predictors of ophthalmic artery occlusion in intra-arterial chemotherapy for retinoblastoma
  1. Ahmad Sweid1,
  2. Kareem El Naamani2,
  3. Kalyan Chekravarthy Sajja3,
  4. Batoul Hammoud4,
  5. Michael D Knapp5,
  6. Daniel D Moylan5,
  7. Daniel Joffe5,
  8. Charles E Morse5,
  9. Daniel Habbal5,
  10. Joshua H Weinberg1,
  11. Stavropoula I Tjoumakaris1,
  12. Carol L Shields6,
  13. David A Lezama6,7,
  14. Li-Anne S Lim6,
  15. Lauren A Dalvin8,
  16. Robert Rosenwasser9,
  17. Pascal Jabbour1
  1. 1 Department of Neurological Surgery, Thomas Jefferson University - Center City Campus, Philadelphia, Pennsylvania, USA
  2. 2 School of Medicine, Lebanese American University, Beirut, Beirut, Lebanon
  3. 3 Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  4. 4 Department of Endocrinology, CHOP, Philadelphia, Pennsylvania, USA
  5. 5 Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
  6. 6 Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  7. 7 Instituto de Oftalmologia y Ciencias Visuales, Tecnologico de Monterrey, Monterrey, Mexico
  8. 8 Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
  9. 9 Department of Neurosurgery, Thomas Jefferson University - Center City Campus, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Pascal Jabbour, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107-5084, USA; pascal.jabbour{at}jefferson.edu

Abstract

Background Retinoblastoma is the most common primary intraocular malignancy in children.

Objective To determine the incidence of ophthalmic artery (OA) occlusion in patients treated with selective ophthalmic artery catheterization (OAC) for chemotherapy infusion for retinoblastoma. Also, to evaluate technical, anatomical, tumorous, and patient-related factors that are predictors of OA occlusion.

Methods A retrospective chart review was performed for patients diagnosed with intraocular retinoblastoma and managed with intra-arterial chemotherapy (IAC).

Results The total study cohort included 208 retinoblastoma tumors of 208 eyes in 197 consecutive patients who underwent 688 attempted IAC infusions overall with a total of 624 successful OAC infusions. The total incidence of ophthalmic artery thrombosis was 11.1% (23/208). The numbers of successful OAC procedures before diagnosing OA occlusion were one OAC in six cases (27.3%), two in seven cases (31.8%), three in four cases (18.2%), four in one case (4.5%), five in two cases (9.1%), and six in one case (4.5%).

Conclusions Local factors relating to the chemotherapy and selective microcatheterization of the OA are essential factors in the development of OA thrombosis, as seen by the association of OA thrombosis with the frequency of IAC.

  • intervention
  • tumor

Data availability statement

Data are available upon reasonable request from the corresponding author.

https://doi.org/10.1136/neurintsurg-2020-016759

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    Data availability statement

    Data are available upon reasonable request from the corresponding author.

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    Footnotes

    • Twitter @AhmadSweidMD, @PascalJabbourMD

    • Contributors Conception or design of the work: AS, KCS, SIT, PJ. Acquisition of data: KEN, MDK, DDM, DJ, CEM, DH, JHW. Analysis of data: BH. Interpretation of data: AS, LAD. Drafting the work: AS, BH. Revising the work for valuable intellectual content: PJ, CLS, DAL, L-ASL, SIT, RR. Final approval of the version: PJ.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PJ is a consultant for Medtronic and MicroVention. SIT is a consultant for Stryker. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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