Modified Patent Hemostasis Strategy Based on the Platelet Counts for Transradial Access Chemoembolization in Patients with Hepatocellular Carcinoma: A Prospective Single-Center Study

Abstract

Objective This study aimed to investigate the shortest compression time to achieve hemostasis and the optimal hemostasis strategy in patients treated with transradial access chemoembolization (TRA-TACE). Methods From October 2019 to October 2021, 119 consecutive patients with hepatocellular carcinoma (HCC) who underwent 134 sessions of TRA-TACE were included in this prospective single-center study. The compression time was measured by decompressing the device for 30 min, and thereafter, every 10 min after the procedure until complete hemostasis was achieved. Results Technical success was achieved for all TRA procedures. None of the patients experienced major TRA-related adverse events. Minor adverse events occurred in 7.5% of the patients. The mean compression time was 31.8 ± 5.0 min. Factors that may impact hemostasis were analyzed by univariate and multivariate analyses, and a platelet count < 100×10 9 /L ( p = 0.016, odds ratio = 3.942) was found to be an independent factor that could predict the failure to achieve hemostasis within 30 min. For patients with a platelet count < 100×10 9 /L, the compression time required to achieve hemostasis was 60 min. For patients with a platelet count ≥ 100×10 9 /L, the compression time required to achieve hemostasis was 40 min. Conclusion To achieve hemostasis in patients with HCC treated with TRA-TACE, compression for 60 min is sufficient for those with a platelet count < 100×10 9 /L, and compression for 40 min is sufficient for those with a platelet count ≥ 100×10 9 /L.