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Case Reports in Anesthesiology
Volume 2013, Article ID 408670, 3 pages
http://dx.doi.org/10.1155/2013/408670
Case Report

Hemodynamic Instability Induced by Superselective Angiography of the Ophthalmic Artery

1Department of Clinical Anesthesia, Jackson Memorial Hospital, University of Miami, Miami, FL 33136, USA
2Department of Clinical Neurologic Surgery, 201 Pope Life Center, University of Miami, Miami, FL 33136, USA

Received 17 January 2013; Accepted 13 February 2013

Academic Editors: M. Dauri, I.-O. Lee, P. Michalek, and J.-J. Yang

Copyright © 2013 Stephan Klumpp et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Retinoblastoma is one of the most common ophthalmic neoplasms affecting children worldwide. Since its recent introduction, superselective ophthalmic artery injection of chemotherapy with melphalan has significantly reduced the need for enucleation in patients with advanced disease and also shown to have minimal adverse effects on visual acuity as compared to the conventional therapy. Although no severe complications resulting in strokes or deaths have been reported, this treatment modality is not without difficulties. In this case discussion, we describe an event that has occurred to several pediatric patients undergoing superselective angiography of the ophthalmic artery that may be due to an oculopulmonary type reflex causing significant hemodynamic instability and hypoxemia.