Safety, feasibility, and comfort of hepatic angiography and transarterial intervention with radial access for hepatocellular carcinoma

Abstract

Background and Aim Hepatic angiography procedures such as transarterial chemoembolization (TACE) are essential procedures for managing patients with hepatocellular carcinoma (HCC), and are usually performed with femoral access. However, femoral access causes patient discomfort and may be associated with the risk of hematoma or pseudoaneurysm at puncture site. We evaluated the safety, feasibility, and patient comfort of hepatic angiography procedures performed with radial access. Methods In this single‐institution, retrospective, time‐frame study, a total of 206 patients who underwent hepatic angiography procedures with radial access, which were first used on October 2017 at our institution, were compared with 240 patients who underwent the same procedures with femoral access before this period. Several measures were assessed, including procedure time and safety. In addition, a questionnaire was used to compare the access types regarding procedure‐associated discomfort. Results Hepatic angiography procedures performed with radial access, including TACE, were completed in all patients without complications. The procedure time was comparable between radial access and femoral access. Most patients preferred radial to femoral access. Patients taking anticoagulants were able to complete the procedures without discontinuing these drugs. Conclusions Hepatic angiography procedures with radial access resulted in less discomfort than those with femoral access, and the two approaches showed similar feasibility and safety. Radial access can be introduced as a routine technique for hepatic angiography procedures.

Skill Proficiency, Efficacy, and Safety of the Transradial Approach in Transarterial Treatments for Hepatocellular Carcinoma

“…However, no difference was observed in the procedural success rate or complication rate. Toyoda et al reported that this technique can be learned in a year [ 6 ]. Patients aged 80 years had a history of and a higher risk for cardiovascular events.…”

“…Furthermore, compared with TFA, TRA has better outcomes in liver cancer treatment, is associated with a lower incidence of complications and a shorter hospital stay, and has medical economic advantages [4,5]. Recently, in Japan, TRA has been found to be safe and useful [6][7][8]. In addition to improving treatment efficacy, minimally invasive treatment is an important element in light of a recent medical trend.…”