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March 1, 1965

Selective Concentration of Anticancer Drugs in the Liver: Hepatic-Artery Infusion and Induced Hepatic Outflow Block

Author Affiliations

From the Department of Surgery, St. Vincent's Hospital, and the Medical Center, New York University School of Medicine.

JAMA. 1965;191(9):707-710. doi:10.1001/jama.1965.03080090021005

Selective concentration of drugs infused in the liver via the hepatic artery was produced by the introduction of a double balloon catheter with internal bypass into the vena cava in a dog and inflating the balloons at the level of hepatic veins for ten minutes. Control studies in 40 dogs showed that dogs could tolerate ten minutes of total hepatic-outflow block. In 20 dogs, 0.4 mg mechlorethamine hydrochloride was administered via the hepatic artery with temporary outflow block; all of the dogs survived. Similar results were found with fluorouracil. Radiological and biochemical studies showed drug stasis in the liver during block. This technique may become applicable to the use of short acting alkylating agents, antibiotics, or antimetabolites in hepatic-artery infusion chemotherapy. Pilot studies applying outflow block during hepatic-artery infusion have begun in humans.