Endovascular Infusion of Amphotericin B for the Treatment of Rhino-Orbito-Cerebral Mucormycosis: A Pilot Study Assessing Technical Feasibility and Safety

Abstract

Objectives The aim of this study was to assess the technical feasibility and safety of intra-arterial infusion of amphotericin B for the management of rhino-orbito-cerebral mucormycosis in patients unable to receive full dose and schedule of intravenous amphotericin B and/or unsuitable for surgery. Materials and Methods Five consecutive patients underwent five sessions of intra-arterial infusion each via both external carotid arteries on alternate days. Liposomal amphotericin B (50 mg) was infused at each session. The baseline and follow-up investigations as well as local and systemic complications were charted. Results Procedure could be completed for all participants without any local complications. One patient had transient and another had progressive deterioration in renal parameters during the follow-up period of 30 days. Conclusions Authors conducted successfully a pilot study of multisession intra-arterial infusion of amphotericin B, with the premise that it can provide high concentration of drug at the desired site with reduced systemic complications. They recommend further larger randomized studies to evaluate its efficacy for the management of advanced rhino-oculo-cerebral mucormycosis.

Keywords

• mucormycosis
• rhino-orbito-cerebral
• covid-19
• amphotericin b
• endovascular