Middle meningeal artery occlusion for intra-arterial chemotherapy of retinoblastoma

Interv Neuroradiol. 2019 Jun;25(3):335-337. doi: 10.1177/1591019918815286. Epub 2018 Nov 28.


We report the intentional occlusion of the middle meningeal artery arising from the lacrimal artery, a novel technique to improve drug delivery in a 14-month-old boy with a history of right sporadic unilateral cavitary retinoblastoma group D. The patient was referred to our institution for intra-arterial chemotherapy after two systemic chemotherapy treatments. The digital subtraction angiography showed a large middle meningeal artery arising from the right lacrimal artery and decrease choroidal enhancement thus decreased flow to the tumor. The ophthalmological examination after the first intra-arterial chemotherapy observed no tumor regression. Assuming a vascular steal, in the second intra-arterial chemotherapy session, the origin of the middle meningeal artery was occluded. Following this treatment, a significant response was observed at ophthalmological follow up. In the presented case, the efficacy of intra-arterial chemotherapy was improved after occlusion of a meningeal branch arising from the lacrimal artery, which was responsible for the vascular steal.

Keywords: Intra-arterial chemotherapy; ophthalmic artery; retinoblastoma.

Publication types

  • Case Reports

MeSH terms

  • Angiography, Digital Subtraction
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / therapeutic use*
  • Humans
  • Infant
  • Infusions, Intra-Arterial / methods*
  • Magnetic Resonance Imaging, Interventional
  • Male
  • Meningeal Arteries / surgery*
  • Retinal Neoplasms / drug therapy*
  • Retinoblastoma / drug therapy*
  • Treatment Outcome


  • Antineoplastic Agents