Article
The frameless placement of convection-enhanced delivery catheters: experiences with more than 50 placed catheters for chemotherapy
Rahmenlose Platzierung von Kathetern für die Convection Enhanced Delivery: Erfahrungen nach der Anlage von über 50 Chemotherapiekathetern
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Published: | May 8, 2006 |
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Objective: Convection enhanced delivery of chemotherapeutics will be the upcoming adjuvant therapy for glioblastoma multiforme. Catheter placement and infusion therapy can cause major complications. We present our experience with frameless catheter placement and infusion therapy.
Methods: As part of multiple convection enhanced chemotherapy trials for glioblastoma multiforme we placed 51 catheters in 21 patients. We retrospectively analyzed our data, looked for difficulties and complications in frameless placement and convection enhanced delivery without focusing on the distinct problems within the different trials.
Results: In our series there were 2 minor bleedings surrounding the catheter tip and no major. In one patient there was a questionable abscess in the resection cavity more likely a reaction to chemotherapy. In one patient of a trial with a permanent catheter the later caused an intracranial abscess and encephalitis. 2 catheters had to be revised because of wrong positioning. The problem within our series was depth control: Several catheters were inserted deeper than planed.
Conclusions: Frameless placement of intracranial chemotherapy catheters and convection enhanced delivery is safe with a low complication rate. Due to the infusions characteristics most critical is the correct placement of the catheters. Frame based placement is very accurate but time consuming, less flexible and only available in major centres. We think in future frameless placement will be mostly used. For easy and accurate frameless placement of convection enhanced delivery catheters further tools need to be developed that should be of low cost to be widely available for future glioblastoma therapy.