Hepatic artery model for evaluating the distribution of intraarterial chemotherapy infusion: Nonpulsed versus pulsed infusions

The effect of a commercially available pulsatile slow-infusion system on the degree of infusate mixing and distribution was assessed in a life-size glass model of the hepatic arterial system. The authors determined, both visually and quantitatively, the mixing homogeneity of a low-flow infusion (1.4 mL/min) of red dye through a side-hole catheter (2.5 F outer diameter) into pulsatile flow (300 mL/min) of a fluid with the same viscosity as blood. When comparing nonpulsed versus pulsed infusion techniques, the authors found that the pulsatile infusion system did not significantly improve the inhomogeneity of dye distribution in the 16 hepatic arterial branches. The results of this in vitro study suggest that a pulsatile infusion system that uses low pulse velocities without regard for cardiac cycle is less than optimal and does not significantly improve drug mixing at the standard slow infusion rates. Moreover, as potential new intraarterial delivery systems are developed to improve drug mixing, in vitro models may be the most useful means of initially evaluating their efficacy.