Joshi Shailendra, Emala Charles W, Pile-Spellman John
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
J Neurosurg Anesthesiol. 2007 Apr;19(2):111-9. doi: 10.1097/ANA.0b013e318033da41.
The therapeutic potential of intra-arterial (IA) drug delivery to the brain has received limited attention in the last decade. In the 1980s, efforts to treat brain tumors with IA chemotherapy, the leading application of this technology, yielded modest results. Poor control of tissue drug concentrations and the potential risk of permanent neurologic injury further prevented the wider use of IA drugs. Yet, IA drugs were anecdotally used for treating a wide spectrum of brain diseases. Recent advances in endovascular technology and the increased safety of angiographic procedures now compel us to reevaluate IA drug delivery. This review describes the pharmacologic principles, applications, and pitfalls of IA drug delivery to the brain.
在过去十年中,脑内动脉(IA)给药的治疗潜力受到的关注有限。在20世纪80年代,作为该技术的主要应用,用IA化疗治疗脑肿瘤的努力取得了一定成果。对组织药物浓度的控制不佳以及永久性神经损伤的潜在风险进一步阻碍了IA药物的广泛使用。然而,IA药物曾被用于治疗多种脑部疾病。血管内技术的最新进展以及血管造影术安全性的提高,促使我们重新评估IA给药。这篇综述描述了IA给药治疗脑部疾病的药理学原理、应用及陷阱。