Transradial Approach for Transcatheter Arterial Chemoembolization in Patients With Hepatocellular Carcinoma

Abstract

We evaluated the clinical usefulness and safety of transradial approach for transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) compared with that of conventional transfemoral approach. The two groups (radial group, n = 177; femoral group, n = 150) of cases were retrospectively compared with regard to the successful rate of angiography or TACE, time required for catheterizaiton and complications. Hepatic angiography and TACE were completed in 174 (98.3%) of 177 cases in the radial group. There was no intergroup difference of time required for catheterization. Minor complications (dull pain, numbness) occurred in 8 (4.6%) patients in the radial group, and there were lower complications in the radial group compared to the femoral group. TACE by our new transradial approach was found to have therapeutic efficacy with lower complications comparable to that of the conventional transfemoral approach.

Hepatic radioembolization from transradial access: initial experience and comparison to transfemoral access

“…According to our knowledge, there are only a few hospitals where radial access is regularly performed for interventions in the systemic circulation. Most of the related publications report the use of radial access for cerebral angiograms and carotid artery stenting (16,17) and only a few report procedures below the diaphragm (11)(12)(13)(14)(15). Only three groups reported abdominal or pelvic visceral interventions in the English literature.…”

“…Only three groups reported abdominal or pelvic visceral interventions in the English literature. A group at Tokyo Women's Medical University Daini Hospital (Tokyo, Japan) reported that they performed abdominal interventions in 426 patients between 2000 and 2004 via the transradial approach, including 177 cases of transarterial hepatic chemoemboli-zations (15,22); Ruzsa et al (14) reported renal artery angioplasty and stenting in 27 patients; Resnick et al (13) reported uterine artery embolization in 29 patients.…”

“…use of radial access for procedures in the systemic circulation (11)(12)(13)(14)(15), and the majority of these reports are related to cerebral angiograms and carotid stenting (16,17). According to our knowledge, there is only one peer-reviewed publication which compares radial to femoral approach for a procedure in the systemic circulation (15); Shiozawa et al (15) investigated the therapeutic efficacy and safety of the transradial approach for transarterial chemoembolization in patients with hepatocellular carcinoma and compared it with the conventional transfemoral approach. However, there is no available data comparing fluoroscopy time and radiation dose of procedures in the systemic circulation performed via transradial versus transfemoral access.…”

Impact of Branched-Chain Amino Acid-Enriched Nutrient on liver Cirrhosis with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization in Barcelona Clinic Liver Cancer Stage B: A Prospective Study

“…As previously reported 16,17 , a 4-Fr catheter was inserted into the left radial artery, and super selective embolization was performed on the tumor with staining on hepatic arteriography concurrently using a microcatheter in the TACE procedure. Miriplatin (miriplatin hydrate, Sumitomo Dainippon Pharma Co., Ltd, Osaka, Japan) 40 to 80 mg/body and iodized oil (Lipiodol; Lipiodol Ultrafluide, Laboratoire Guerbet, Aulnay-sous-Bois, France) were mixed at an equal ratio and injected during the embolization according to the diameter and number of tumors.…”

A Technical Guide Describing the Use of Transradial Access Technique for Endovascular Interventions

“…In 2003, TACE using TRA was first described in Japan. 18 Shiozawa et al retrospectively compared 150 TACE patients who underwent TFA and 177 patients who underwent TRA. Of the 70 patients who received both approaches, 92.9% preferred TRA.…”