{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:20:42Z","timestamp":1790184042666,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cerebral intra-arterial chemotherapy (CIAC) has been demonstrated to achieve tumoricidal concentrations in cerebral tumour cells that are otherwise unachievable due to the presence of the blood\u2013brain barrier. In this study, we sought to analyze the safety of CIAC in a cohort of patients treated at the Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Estrie\u2014Centre hospitalier universitaire de Sherbrooke (CIUSSS-CHUS). Methods: Treatments consisted of monthly CIAC. A neurological examination and neuroimaging study (MRI) were performed before every treatment. The files of patients enrolled in our CIAC programme were reviewed. Adverse events were analyzed and categorized. Results: Overall, 2991 CIAC procedures were performed in 642 patients. Pathologies were as follows: malignant gliomas (68.7%), cerebral metastasis (17.6%), and cerebral lymphomas (13.7%). Perfusion vessels were as follows: 80% internal carotid artery and 20% vertebral artery. The chemotherapeutic agents used were carboplatin (86.4%), methotrexate (28.5%), melphalan (28.6%), and liposomal doxorubicin (2.8%). Osmotic blood\u2013brain barrier disruption (BBBD) was induced in 30.5% of treatments. Symptomatic vascular adverse events occurred during 27 procedures (0.9%) in 26 patients (4%). Namely, 23 strokes, one carotid artery occlusion (responsible for one of the strokes), and two intratumoral and one subdural hemorrhage. The absolute risk of stroke was 1.3% and 0.5% for CIAC with or without BBBD, respectively. The use of the vertebral artery significantly increased the risk of stroke. Drug infusion-related seizures occurred in 2.5% of patients; 83.8% were associated with methotrexate and 16.2% with carboplatin. Conclusions: CIAC is a safe procedure with a 0.9% overall rate of symptomatic complications (stroke, carotid occlusion, subdural hemorrhage or intratumoral bleeding\u2014n = 27\/2991) on a treatment basis, mainly consisting of strokes (85%, n = 23), with a modified NIH Stroke Scale score of 4.1 \u00b1 3.3.<\/jats:p>","DOI":"10.3390\/jcm14020524","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T09:01:02Z","timestamp":1736931662000},"page":"524","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Safety of Cerebral Intra-Arterial Chemotherapy for the Treatment of Malignant Brain Tumours"],"prefix":"10.3390","volume":"14","author":[{"given":"G\u00e9rald","family":"Gahide","sequence":"first","affiliation":[{"name":"Department of Medical Imaging, Division of Interventional Radiology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"},{"name":"Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Universitaire de Sherbrooke, 12e Avenue Nord, Porte 6, Sherbrooke, QC J1H 5N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0351-2696","authenticated-orcid":false,"given":"Jean-Fran\u00e7ois","family":"Vendrell","sequence":"additional","affiliation":[{"name":"Institut de Canc\u00e9rologie de Montpellier, Clinique de Val d\u2019Aurelle, 34090 Montpellier, Cedex 5, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-9447","authenticated-orcid":false,"given":"Karine","family":"Massicotte-Tisluck","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Division of Interventional Radiology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Caux","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Division of Interventional Radiology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"},{"name":"The Health Campus, Universit\u00e9 de Sherbrooke, 3001 12e Avenue Nord, Immeuble X1, Sherbrooke, QC J1H 5N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Deschamps","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Division of Interventional Radiology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"},{"name":"The Health Campus, Universit\u00e9 de Sherbrooke, 3001 12e Avenue Nord, Immeuble X1, Sherbrooke, QC J1H 5N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"No\u00ebl-Lamy","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Division of Interventional Radiology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Belzile","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Division of Interventional Radiology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent-Olivier","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery and Neuro-Oncology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fortin","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Universitaire de Sherbrooke, 12e Avenue Nord, Porte 6, Sherbrooke, QC J1H 5N4, Canada"},{"name":"Department of Surgery, Division of Neurosurgery and Neuro-Oncology, Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2014Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC J1H 5H3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Blakeley, J. (2008). Drug Delivery to Brain Tumors. Curr. Neurol. Neurosci., 8.","DOI":"10.1007\/s11910-008-0036-8"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1038\/s41578-021-00394-w","article-title":"Drug Delivery to the Central Nervous System","volume":"7","author":"Nance","year":"2022","journal-title":"Nat. Rev. Mater."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Yousef, Y.A., Soliman, S.E., Astudillo, P.P.P., Durairaj, P., Dimaras, H., Chan, H.S.L., H\u00e9on, E., Gallie, B.L., and Shaikh, F. (2016). Intra-Arterial Chemotherapy for Retinoblastoma: A Systematic Review. JAMA Ophthalmol., 134.","DOI":"10.1001\/jamaophthalmol.2016.0244"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1038\/s41575-020-00395-0","article-title":"Locoregional Therapies in the Era of Molecular and Immune Treatments for Hepatocellular Carcinoma","volume":"18","author":"Llovet","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s11864-005-0030-1","article-title":"Intra-Arterial Chemotherapy of Primary Brain Tumors","volume":"6","author":"Newton","year":"2005","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1097\/00006123-199805000-00082","article-title":"Outwitting the Blood-Brain Barrier for Therapeutic Purposes: Osmotic Opening and Other Means","volume":"42","author":"Kroll","year":"1998","journal-title":"Neurosurgery"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1152\/ajpregu.1977.232.1.R45","article-title":"CNS, CSF, and Extradural Fluid Uptake of Various Hydrophilic Materials in the Dogfish","volume":"232","author":"Fenstermacher","year":"1977","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s11910-024-01338-x","article-title":"de Strategies to Improve Drug Delivery Across the Blood\u2013Brain Barrier for Glioblastoma","volume":"24","author":"Narsinh","year":"2024","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s11060-013-1238-8","article-title":"Optimization of the Route of Platinum Drugs Administration to Optimize the Concomitant Treatment with Radiotherapy for Glioblastoma Implanted in the Fischer Rat Brain","volume":"115","author":"Charest","year":"2013","journal-title":"J. Neuro-Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s11060-014-1504-4","article-title":"Intra-Arterial Carboplatin as a Salvage Strategy in the Treatment of Recurrent Glioblastoma Multiforme","volume":"119","author":"Fortin","year":"2014","journal-title":"J. Neuro-Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Iorio-Morin, C., Gahide, G., Morin, C., Vanderweyen, D., Roy, M.-A., St-Pierre, I., Massicotte-Tisluck, K., and Fortin, D. (2021). Management of Primary Central Nervous System Lymphoma Using Intra-Arterial Chemotherapy With Osmotic Blood-Brain Barrier Disruption: Retrospective Analysis of the Sherbrooke Cohort. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.543648"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00234-007-0252-y","article-title":"Complications of Cerebral Angiography: A Prospective Analysis of 2924 Consecutive Procedures","volume":"49","author":"Dawkins","year":"2007","journal-title":"Neuroradiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jvir.2009.01.012","article-title":"Complications of Modern Diagnostic Cerebral Angiography in an Academic Medical Center","volume":"20","author":"Fifi","year":"2009","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1136\/neurintsurg-2020-016604","article-title":"Intraoperative Vascular Complications during 2278 Cerebral Endovascular Procedures with Multimodality IONM: Relationship between Signal Change, Complication, Intervention and Postoperative Outcome","volume":"13","author":"Wilent","year":"2021","journal-title":"J. Neurointerv. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/(SICI)1097-0142(20000201)88:3<637::AID-CNCR22>3.0.CO;2-Y","article-title":"Safety and Efficacy of a Multicenter Study Using Intraarterial Chemotherapy in Conjunction with Osmotic Opening of the Blood-Brain Barrier for the Treatment of Patients with Malignant Brain Tumors","volume":"88","author":"Doolittle","year":"2000","journal-title":"Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1200\/JCO.2008.19.3789","article-title":"Blood-Brain Barrier Disruption and Intra-Arterial Methotrexate-Based Therapy for Newly Diagnosed Primary CNS Lymphoma: A Multi-Institutional Experience","volume":"27","author":"Angelov","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1007\/s11912-024-01497-7","article-title":"Blood\u2013Brain Barrier Disruption for the Treatment of Primary Brain Tumors: Advances in the Past Half-Decade","volume":"26","author":"Virtanen","year":"2024","journal-title":"Curr. Oncol. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1093\/neuonc\/noy195","article-title":"Malignant Primary Brain and Other Central Nervous System Tumors Diagnosed in Canada from 2009 to 2013","volume":"21","author":"Walker","year":"2019","journal-title":"Neuro Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1093\/neuonc\/noy164","article-title":"Glioblastoma Survival Is Improving despite Increasing Incidence Rates: A Nationwide Study between 2000 and 2013 in Finland","volume":"21","author":"Korja","year":"2018","journal-title":"Neuro Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1001\/archneur.59.1.35","article-title":"Targeting Neurotherapeutic Agents Through the Blood-Brain Barrier","volume":"59","author":"Pardridge","year":"2002","journal-title":"Arch. Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drup.2015.02.002","article-title":"Overcoming the Blood\u2013Brain Tumor Barrier for Effective Glioblastoma Treatment","volume":"19","author":"Wesseling","year":"2015","journal-title":"Drug Resist. Updates"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.2174\/1381612826666200318130625","article-title":"Expression of P-Gp in Glioblastoma: What We Can Learn from Brain Development","volume":"26","author":"Errede","year":"2020","journal-title":"Curr. Pharm. Des."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1227\/00006123-199507000-00003","article-title":"Toxicity and Efficacy of Carboplatin and Etoposide in Conjunction with Disruption of the Blood-Brain Tumor Barrier in the Treatment of Intracranial Neoplasms","volume":"37","author":"Williams","year":"1995","journal-title":"Neurosurgery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1023\/A:1010683128853","article-title":"Superselective Intra-Arterial Carboplatin for Treatment of Intracranial Neoplasms: Experience in 100 Procedures","volume":"51","author":"Qureshi","year":"2001","journal-title":"J. Neuro-Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s11060-020-03435-6","article-title":"Super Selective Intra-Arterial Cerebral Infusion of Modern Chemotherapeutics after Blood\u2013Brain Barrier Disruption: Where Are We Now, and Where We Are Going","volume":"147","author":"Khatri","year":"2020","journal-title":"J. Neuro-Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Peschillo, S., Miscusi, M., and Missori, P. (2015). Endovascular Superselective Treatment of Brain Tumors: A New Endovascular Era? A Quick Review. J. Neurointerv. Surg., 7.","DOI":"10.1136\/neurintsurg-2013-011095"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1007\/s12094-013-1114-1","article-title":"Tackling Gliomas with Nanoformulated Antineoplastic Drugs: Suitability of Hyaluronic Acid Nanoparticles","volume":"16","author":"Ganau","year":"2014","journal-title":"Clin. Transl. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"15","DOI":"10.32604\/or.2024.053069","article-title":"Engendered Nanoparticles for Treatment of Brain Tumors","volume":"33","author":"Soleymani","year":"2024","journal-title":"Oncol. Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Abousalman-Rezvani, Z., Refaat, A., Dehghankelishadi, P., Roghani-Mamaqani, H., Esser, L., and Voelcker, N.H. (2024). Insights into Targeted and Stimulus-Responsive Nanocarriers for Brain Cancer Treatment. Adv. Healthc. Mater., 13.","DOI":"10.1002\/adhm.202302902"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5301\/tj.5000215","article-title":"Radiosurgical Options in Neuro-Oncology: A Review on Current Tenets and Future Opportunities. Part II: Adjuvant Radiobiological Tools","volume":"101","author":"Ganau","year":"2014","journal-title":"Tumori J."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lundy, D.J., Nguy\u1ec5n, H., and Hsieh, P.C.H. (2021). Emerging Nano-Carrier Strategies for Brain Tumor Drug Delivery and Considerations for Clinical Translation. Pharmaceutics, 13.","DOI":"10.3390\/pharmaceutics13081193"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s10637-016-0340-0","article-title":"Convection-Enhancement Delivery of Liposomal Formulation of Oxaliplatin Shows Less Toxicity than Oxaliplatin yet Maintains a Similar Median Survival Time in F98 Glioma-Bearing Rat Model","volume":"34","author":"Shi","year":"2016","journal-title":"Investig. New Drugs"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/2\/524\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:29:12Z","timestamp":1759919352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/2\/524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jcm14020524"],"URL":"https:\/\/doi.org\/10.3390\/jcm14020524","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]}}}