Chemo Immuno Precision Injections (CIPI™)

EnvitaIR’s™ Approach to Precision Care That Surpasses Conventional Thinking

Envita Medical Centers, a center of excellence for precision oncology, is one of the leading integrative medical facilities in the world. We are always innovating and improving the methods we use to treat our patients which is why we have developed Envita’s Interventional Radiology department called EnvitaIR™. EnvitaIR™ is proud to present Chemo Immuno Precision Injections (CIPI™) as a minimally invasive procedure designed to treat fibrous tumors that are too difficult to treat through traditional intravenous chemotherapy administration.

CIPI™ is EnvitaIR’s™ new and exciting way to precision target fibrous tumors that are too large, too numerous, or too invasive to be considered eligible for surgical removal. CIPI™ is non-surgical and minimally invasive, meaning it can provide precision targeted therapy while avoiding the damage surgery can cause to the body and the immune system. CIPI™ can also increase absorption of Envita’s genetically targeted chemotherapy, increasing the potential cancer killing effect of these personalized medications while reducing the chance of damaging healthy cells and causing negative side-effects.

How Does CIPI™ Work?

A microcatheter (a thin flexible tube) is feed through a small incision into the blood vessel to the major artery of the tumor. Small beads are then injected into the artery, obstructing the direct blood flow to the tumor, starving it of nutrients it needs to grow. The beads are also coated in a patient-personalized combination of micro-dosed chemotherapies, genetically targeted to the patient’s cancer biomarkers. These genetically targeted chemotherapies are slowly released over time, further targeting the tumor in a controlled fashion. The beads are designed to deliver a high, localized dose of genetically targeted chemotherapies to the tumor while causing minimal damage to healthy cells.

What to Expect Before the Procedure?

You must stop eating 8 hours before the procedure, it is okay to have clear liquids up to 2 hours before the procedure.

You must stop any blood thinning medications (Coumadin, Lovenox, Plavix) before the procedure. Your Envita physician will help you with information on how long before the procedure you will need to stop taking these medications.

You should also make sure you have someone to drive you home after the procedure.

What to Expect During the Procedure?

The procedure can last from 30 minutes to 2 hours. You will be put under conscious sedation, which means you will still be able to talk to the nurse and doctor in the room but will feel very relaxed and may not remember everything related to the procedure.

The procedure will begin with an injection of X-ray contrast material so that your cancer doctor will be able to visualize the arteries in and around the tumor(s). The doctor will insert the catheter into one of your blood vessels through a tiny incision in the skin and then guide the tube into position with assistance of x-ray visualization.

X-ray fluoroscopy allows the doctor to see the arteries and veins inside your body and to guide the catheter into the correct place to release the beads.

You will be awake for the entire procedure; local anesthesia is used at the incision site where the catheter is introduced into the blood vessel system. The doctor will take pictures of the blood vessel system both before and after the procedure so that comparisons can be made to ensure that blood flow to the tumor(s) has been blocked off successfully. The incision will be so small that it will not need stitches after the procedure is finished, although sometimes a closure device will be used to close the hole afterwards to prevent bleeding.

What to Expect After the Procedure?

The incision will be covered with a dressing and then you will be taken into the recovery room to rest for a while.

You can expect to stay on our recovery bed for 4-6 hours, after which, you’ll be able to go home.

After the procedure, many patients experience post-embolization symptoms which can include: Pain, Nausea, Vomiting, or Fever.

These symptoms are normal and are a result of the blood supply to the treated area being blocked off. The symptoms are readily controlled by medication and fade with time. You may run a fever for up to a week following the procedure.

If the pain suddenly changes in degree or character, or the fever becomes suddenly higher, you should contact your physician right away.

What to Expect When you Get Home

Take it easy for the rest of the day. Do not lift anything over 5 pounds for the next 48 hours.

Change the dressing as needed, your nurse will give you information on how to change your dressing.

You may be given prescriptions for pain and anti-nausea by your provider.

You may shower but avoid submerging in water such as bath or swimming for 7 days.

If you have any bleeding from the puncture site:

Lie down flat with your leg straight
Apply direct, constant, firm pressure for 10 to 15 minutes. The bleeding should stop

If it does not, maintain pressure and call your doctor immediately or go to the Emergency Department.

Resume your regular diet. Drink an extra 3 to 4 glasses of fluid.

What are the Risks of CIPI™?

Any procedure where the skin is broken carries a potential risk of infection. However, the highly trained staff at EnvitaIR™ will do all they can to mitigate the risks of infection before and after the procedure.

Any procedure where a catheter is placed inside of a blood vessel also carries certain risks, including:

Damage to the blood vessel
Bruising and bleeding at the puncture site
Possible infection

There is a chance that the embolization material (beads) will lodge in the wrong place and cut off blood supply to normal tissue. Mapping of the blood pathways of the tumor and surrounding tissue ahead of time minimizes this risk.

There is a small chance that you will have an allergic reaction to the contrast material used for the x-ray fluoroscopy. Your doctor will discuss potential allergies with you before the procedure.

Reactions to the chemotherapy released by the embolization beads may include nausea, hair loss, a decrease in white blood cells, or anemia. However, because CIPI™ traps most of the chemotherapy agent in the beads released into the tumor, and because of Envita’s micro-dose chemotherapy methods, these reactions can be very mild.

Major complications can occur in about 1 in 20 patients receiving CIPI™. These complications can involve an infection in the liver or damage to the liver.

What to Watch Out for After Treatment

You need to pay close attention to your body around the time of 5 to 14 days after your procedure. Look for any signs of infection. Go to the closest hospital Emergency Department if you have:

A new rise in temperature of 38 °C (100.4 °F) or higher

Signs of infection

Chills or shakes

Burning when you urinate

Cough with yellow or green sputum

A wound that is red, hot, or draining

A sore throat

Frequent diarrhea (watery, or loose stool)

It is important that you go to the closest Emergency Department if you notice any of these signs of infection, since you may need treatment right away. Tell them you have just had a Transcatheter arterial chemoembolization procedure performed.

Envita’s Promise

EnvitaIR™ is comprised of an expert team of interventional oncologists who are among the most qualified in the country at the combination of conventional and natural medicine. We wish to offer you the most sophisticated and advanced medical techniques that science has to offer combined with holistic and supportive natural medicine to target your whole healthcare needs. If you have any further questions or concerns about the CIPI™ procedure, please do not hesitate to ask your Envita nurse or Physician for further clarification.