Journal of Skin Cancer / 2011 / Article / Tab 3

Review Article

Treatment of Locally Advanced Melanoma by Isolated Limb Infusion with Cytotoxic Drugs

Table 3

Differences between isolated limb perfusion and isolated limb infusion.

Isolated limb perfusionIsolated limb infusion

Technically complexTechnically simple
Open surgical exposure of vessels for catheter insertionPercutaneous vascular catheter insertion in radiology department
4 to 6 hours durationApproximately 1 hour
Perfusionist and large number of staff requiredNo perfusionist required and fewer total staff
Complex and expensive equipment neededEquipment requirements modest
Magnitude of procedure excludes patientsWell tolerated by medically compromised, frail, and elderly patients
Not possible in occlusive vascular diseaseCan be performed in occlusive vascular disease
Technically challenging to perform a repeat procedureNot difficult to perform a repeat procedure
Systemic metastases normally a contraindicationSystemic metastases not a contraindication
Higher perfusion pressures predispose to systemic leakageLow pressure system, effective vascular isolation with tourniquet
Limb tissues oxygenated, with normal blood gases maintainedProgressive hypoxia and acidosis
Hyperthermia (>41°C can be achieved)Usually not possible to raise limb temperature above 40°C
General anesthesia requiredPossible with regional anesthesia