CC BY 4.0 · The Arab Journal of Interventional Radiology 2023; 07(01): 022-025
DOI: 10.1055/s-0042-1758673
Original Article

Retrospective Comparative Study to Assess the Safety and Efficacy of Transradial Arterial Access for Hepatic Tumor Embolizations: A Single Operator Experience

Ramanivas Sundareyan
1   Department of Interventional Radiology, University Hospitals Birmingham NHS Trust, United Kingdom
,
1   Department of Interventional Radiology, University Hospitals Birmingham NHS Trust, United Kingdom
› Author Affiliations

Abstract

Objectives To assess the efficacy and safety of transradial arterial access (TRA) for hepatic tumor embolizations and compare the outcomes between the TRA and transfemoral arterial access (TFA).

Materials and Methods A retrospective analysis of all consecutive hepatic tumor embolization procedures done through TFA or TRA by a single operator from November 2017 to April 2019 was performed. The procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), conversion and complication rates, and patient preferences were recorded. The primary endpoint was technical success, which was defined as the successful completion of the embolization procedure. Procedural variables including radiation exposure and patient preferences, and complications were analyzed as secondary endpoints.

Results Out of 102 procedures in 90 patients, 44 were performed through TFA and the rest by TRA. A technical success rate of 98.2% and a crossover rate of 1.7% were recorded for TRA. There were no major vascular complications and similar rates of minor complications (8.6% for TRA, 2.3% for TFA; P = 0.055), without any clinical sequelae. After the initial learning curve, no significant differences for other procedural variables were noted between the two access sites. Faster ambulation were achieved following TRA (P < 0.055). All 12 patients who underwent repeat TACE after initial TRA chose this again over TFA.

Conclusions TRA is safe and effective for hepatic tumor embolization. Its safety and efficacy profile is comparable to that of TFA, with added improved patient comfort and faster ambulation.

Advances in Knowledge New catheter options and modifications of the existing techniques as explained in this article proved radial arterial access as a safe and effective alternative in hepatic arterial embolization.



Publication History

Article published online:
19 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Sieghart W, Hucke F, Peck-Radosavljevic M. Transarterial chemoembolization: modalities, indication, and patient selection. J Hepatol 2015; 62 (05) 1187-1195
  • 2 Del Prete M, Fiore F, Modica R. et al; Multidisciplinary Group for NeuroEndocrine Tumors of Naples. Hepatic arterial embolization in patients with neuroendocrine tumors. J Exp Clin Cancer Res 2014; 33: 43
  • 3 Brown DB, Cardella JF, Sacks D. et al. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol 2006; 17 (2 Pt 1): 225-232
  • 4 Rammohan A, Sathyanesan J, Ramaswami S. et al. Embolization of liver tumors: Past, present and future. World J Radiol 2012; 4 (09) 405-412
  • 5 Miraglia R, Pietrosi G, Maruzzelli L. et al. Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma. World J Gastroenterol 2007; 13 (21) 2952-2955
  • 6 Almeida MH, Meireles GCX, Siva EV. et al. Percutaneous coronary intervention using the radial and femoral approaches: comparison between procedure-related discomforts and costs. Rev Bras Cardiol Invasiva 2013; 21: 373-377
  • 7 Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol 1997; 29 (06) 1269-1275
  • 8 Jolly SS, Yusuf S, Cairns J. et al; RIVAL trial group. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet 2011; 377 (9775): 1409-1420
  • 9 Romagnoli E, Biondi-Zoccai G, Sciahbasi A. et al. Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study. J Am Coll Cardiol 2012; 60 (24) 2481-2489
  • 10 Bernat I, Horak D, Stasek J. et al. ST-segment elevation myocardial infarction treated by radial or femoral approach in a multicenter randomized clinical trial: the STEMI-RADIAL trial. J Am Coll Cardiol 2014; 63 (10) 964-972
  • 11 Shiozawa S, Tsuchiya A, Endo S. et al. Transradial approach for transcatheter arterial chemoembolization in patients with hepatocellular carcinoma: comparison with conventional transfemoral approach. J Clin Gastroenterol 2003; 37 (05) 412-417
  • 12 Kis B, Mills M, Hoffe SE. Hepatic radioembolization from transradial access: initial experience and comparison to transfemoral access. Diagn Interv Radiol 2016; 22 (05) 444-449
  • 13 Bishay VL, Biederman DM, Ward TJ. et al. Transradial approach for hepatic radioembolization: initial results and technique. AJR Am J Roentgenol 2016; 207 (05) 1112-1121
  • 14 Wu T, Sun R, Huang Y. et al. Transradial arterial chemoembolization reduces complications and costs in patients with hepatocellular carcinoma. Indian J Cancer 2015; 52 (Suppl. 02) e107-e111
  • 15 Omary RA, Bettmann MA, Cardella JF. et al; Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol 2003; 14 (9 Pt 2): S293-S295
  • 16 US Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events, v4.03. 2010 Accessed April 3, 2017 at: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010–06–14_QuickReference_8.5x11.pdf
  • 17 Cooper CJ, El-Shiekh RA, Cohen DJ. et al. Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison. Am Heart J 1999; 138 (3 Pt 1): 430-436
  • 18 Titano JJ, Biederman DM, Marinelli BS. et al. Safety and feasibility of transradial access for visceral interventions in patients with thrombocytopenia. Cardiovasc Intervent Radiol 2016; 39 (05) 676-682
  • 19 Posham R, Biederman DM, Patel RS. et al. Transradial approach for noncoronary interventions: a single-center review of safety and feasibility in the first 1,500 cases. J Vasc Interv Radiol 2016; 27 (02) 159-166
  • 20 Resnick NJ, Kim E, Patel RS, Lookstein RA, Nowakowski FS, Fischman AM. Uterine artery embolization using a transradial approach: initial experience and technique. J Vasc Interv Radiol 2014; 25 (03) 443-447
  • 21 Ruzsa Z, Tóth K, Jambrik Z. et al. Transradial access for renal artery intervention. Interv Med Appl Sci 2014; 6 (03) 97-103
  • 22 Biederman DM, Marinelli B, O'Connor PJ. et al. Transradial access for visceral endovascular interventions in morbidly obese patients: safety and feasibility. J Vasc Access 2016; 17 (03) 256-260
  • 23 Bhatia S, Harward SH, Sinha VK, Narayanan G. Prostate artery embolization via transradial or transulnar versus transfemoral arterial access: technical results. J Vasc Interv Radiol 2017; 28 (06) 898-905
  • 24 Yuan DZ, Brooks M, Dabin B, Higgs E, Hyun K, Brieger D. Radial versus femoral access for cardiac catheterisation: impact on quality of life. Int J Cardiol 2015; 178: 91-92
  • 25 Joshi KC, Beer-Furlan A, Crowley RW, Chen M, Munich SA. Transradial approach for neurointerventions: a systematic review of the literature. J Neurointerv Surg 2020; 12 (09) 886-892