Extended Isolated Stopflow Limb Infusion (EISLI) | Oncological Clinic Medias in Burghausen, Germany

Extended Isolated Stopflow Limb Infusion (EISLI) is an advanced form of regional chemotherapy designed for malignant tumors of the extremities (arms or legs), especially when the disease is locally advanced, and limb preservation is a priority. It is a modification of isolated limb perfusion/infusion in which the vascular supply of the affected limb is temporarily disconnected from the rest of the body, allowing very high drug exposure in the tumor region with far less whole-body exposure. In practice, EISLI is performed under general anesthesia and uses catheter-based vascular access to deliver cytotoxic drugs directly into the artery supplying the tumor-bearing region, sometimes positioning the arterial catheter tip close to the tumor to further increase local first-pass exposure. A defining element is the brief “stop-flow” phase: after the drug is injected, balloon occlusion is used to transiently halt flow, thereby concentrating the chemotherapy in the target vascular bed and maximizing early tumor uptake before the isolated perfusion/infusion phase proceeds.  After the regional exposure period, the limb (and any extended region treated) is flushed, and normal circulation is restored, thereby limiting systemic toxicity relative to standard intravenous chemotherapy.  In some protocols that use stop-flow balloon systems, blood purification (chemofiltration) is performed after drug delivery to remove residual cytostatics from the circulation and further reduce toxic side effects and cumulative toxicity. EISLI is mainly considered for challenging extremity cancers where conventional surgery alone would be mutilating (or where amputation is being discussed) and where achieving high local drug intensity may downstage the tumor. This clinical niche overlaps with established regional limb chemotherapy indications, such as locally advanced or unresectable extremity soft-tissue sarcoma and advanced limb melanoma (including in-transit disease), and the “extended” approach is specifically intended to address regional lymph node/groin involvement and selected pelvic extension.