Pressure-suit combined with pelvic stop-flow : A feasibility study in a bovine model

Abstract Background Isolated pelvic perfusion exposes tissue to high drug doses and may benefit patients with advanced malignancy. However, leakage is a limit to this technique. Aims The aim of the study is to increase the perfusion ratio between local and systemic compartments on isolated pelvic perfusion. We hypothesised that an inflated pressure-suit placed above the level of aortic and caval stop flow could decrease leakage from the regional to the systemic blood compartment in a bovine model. Method As the size of the pressure-suit was adapted for use in humans, we performed our experimental study on 6 calves which are big enough to fit into the suit. We used an inflated pressure-suit placed at low (40 mmHg) and high pressures (125 mmHg) above the level of aortic and caval stop-flow. A pharmacokinetic study with cisplatinum was performed in both compartments. Results After injection of the drug, the mean ratio of drug concentration in the locoregional/systemic compartment was 43.1. After 30 min, this mean ratio was 4 and 9.7 for a pressure-suit pressure of 40 mmHg and 125 mmHg, respectively. At pressure-suit pressures of 40 mmHg and 125 mmHg, pelvic perfusion achieved pelvic/systemic exposure ratios of 5.9 and 14.9 at 30 min, respectively. Leakage at 30 min was higher when the pressure-suit was inflated at low pressure (40 mmHg, mean 18%). When the pressure-suit was inflated at high pressure, leakage was lower (125 mmHg, mean 7%). Conclusions The pressure-suit increased the perfusion ratio between pelvic and systemic compartments in a bovine model.