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首页> 外文期刊>The Internet Journal of Oncology >Posterior Cerebral Artery Compression and Subsequent Infarction after Implantation of a GliaSite? Balloon
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Posterior Cerebral Artery Compression and Subsequent Infarction after Implantation of a GliaSite? Balloon

机译：植入GliaSite后脑后动脉受压和随后的梗塞？气球

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Objective and Importance: Brachytherapy with the GliaSite? balloon system, is a recently-developed treatment option for recurrent malignant glioma. We report a complication with the intent of supplementing the limited published clinical experience with this device.Clinical Presentation: Following resection of recurrent glioblastoma in the right temporal lobe of a 66 year-old man, a GliaSite? balloon was implanted. Ninety minutes postoperatively, the patient developed left hemiparesis. Imaging revealed an acute infarct within the distribution of the right posterior cerebral artery.Technique: Prior reported clinical experiences were explored to elucidate the potential frequency of neurological deficits associated with balloon inflation, with emphasis on the relative geometries of the balloon and resection cavity.Conclusion: Risk of acute neurological deficits and possible stroke may be underappreciated with the GliaSite? system. Additional investigations into the pressure-volume relationships as a function of resection cavity deviation from spherical shape may be helpful in patient selection and device utilization. Objective and Importance Despite advances in surgery, radiation, and chemotherapy, long-term survival of patients with glioblastoma multiforme (GBM) remains poor, with the vast majority of patients suffering recurrent tumor. Options for treating recurrent GBM include surgery, chemotherapy (systemic or implanted), and/or radiation. Retreatment with radiation requires focal therapy to minimize the volume of normal brain tissue receiving high cumulative doses. Consequently, various forms of brachytherapy have been used to administer radiation in the setting of recurrent GBM. Recently, brachytherapy using the GliaSite? (Proxima Therapeutics Inc., Alpharetta, Georgia, USA) intra-cavitary radiation system has been reported for recurrent malignant glioma.1,2 The GliaSite? device consists of a silicone balloon that comes in a variety of sizes which can be intraoperatively fitted to relatively spherical resection cavities. The device is then after-loaded by filling with an aqueous iodine-125 solution. Consistent spatial localization of the radiation dose is achievable with this relatively rigid spherical balloon system.3 We present a complication associated with use of this system that may be more common than previously recognized. Clinical Presentation A 66 year-old man presented for resection of a recurrent right temporal GBM (Figure 1).
机译：目的和重要性：使用GliaSite进行近距离放射治疗？气囊系统是最近开发的用于复发性恶性神经胶质瘤的治疗选择。我们报道了一种并发症，目的是用这种装置补充有限的公开临床经验。临床表现：切除了66岁男性GliaSite的右颞叶复发性胶质母细胞瘤。植入气球。术后九十分钟，患者发展为左偏瘫。影像学检查显示右脑后动脉分布内有急性梗塞。技术：研究了先前报道的临床经验，以阐明与球囊扩张相关的神经功能缺损的潜在频率，重点是球囊和切除腔的相对几何形状。 ：使用GliaSite可能没有意识到急性神经功能缺损和可能发生中风的风险？系统。作为切除腔偏离球形形状的函数的压力-体积关系的其他研究可能有助于患者选择和设备使用。目的和重要性尽管多形性胶质母细胞瘤（GBM）的患者的长期存活率仍然不佳，但绝大多数患者仍患有复发性肿瘤。治疗复发性GBM的选项包括手术，化学疗法（全身或植入）和/或放射线。放射治疗需要局部治疗，以最大程度减少接受高累积剂量的正常脑组织的体积。因此，在复发性GBM的背景下，已经使用了各种形式的近距离放射治疗来进行放射治疗。最近，使用GliaSite进行近距离放射治疗吗？ （Proxima Therapeutics Inc.，美国乔治亚州阿尔法利塔）据报道，腔内放射系统可用于复发性恶性神经胶质瘤。1,2，GliaSite？装置由各种尺寸的硅胶气囊组成，可以在手术中安装到相对球形的切除腔中。然后通过填充碘125水溶液对设备进行后装。使用这种相对刚性的球形球囊系统可以实现辐射剂量的一致空间定位。3我们提出了与使用该系统相关的并发症，这种并发症可能比以前认识到的更为普遍。临床表现一名66岁的男性被提出切除复发的右颞颞部GBM（图1）。

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