Intra-arterial injection is used to deliver drugs directly to organs, for example, in cancer chemotherapy, and in the use of vasopressin for GI bleeding. Intra-arterial carmustine is effective to treat brain tumors and pelvic intra-arterial actinomycin D is used for malignant trophoblastic disease.
Intra-arterial drug administration has potential safety implications. Embolization, arterial occlusion, and localized drug toxicity have been reported.
The Technique Percutaneous intra-arterial injection is a safe and straightforward procedure, quite suitable for out-patient practice. No special preparation of the patient is required and there is no necessity for an incision to expose the artery.
The groin (the majority of cases involve the lower limbs) is cleaned with iodine or other antiseptic solution,and often no local anaesthetic is required. The femoral pulse is felt at the crural beat and while the left hand palpates and 'immobilizes' the artery, the needle-with syringe attached-is passed into the vessel.
The manoeuvre is simple, and though there is no visual guide to the artery the left palpating hand serves as a reliable pathfinder. Accuracy is further facilitated by pelvic elevation and extension-and-rotation of the limb -a practical point well worth noting, especially if the patient happens to'be in' a sagging bed. A zo20 cc.
Record syringe fitted with a long and wide-bored needle is satisfactory. We have found the 5 cm. long, size II, III' or IV serum needles, most suitable. One important point, it is essential that the needle be sharp-pointed and shortbevelled.
Edwards and Watson advise that the technique is further facilitated by directing'the needle against the blood stream, but in our experience it is easier to inject with the stream. Accuracy of arterial puncture is manifest by the strong pulsation which tends to push back the plunger.
The technique of injecting is the same as in any other vessel except that it must be done particularly cautiously and slowly. Mufson has employed a drip method, but this is rarely necessary.
The injection terminated, it is important that the needle be withdrawn quickly and local pressure applied at the site of puncture for a few minutes, otherwise there is a tendency to extravasation and haematoma formation.
Reference : http://pmj.bmj.com/content/31/351/30.full.pdf