Department of Interventional Radiology, Changzheng Hospital, The Second Military Medical University, Shanghai, 200003, China.
Abdom Radiol (NY). 2019 Sep;44(9):3195-3199. doi: 10.1007/s00261-019-02072-6.
The purpose of this study was to retrospectively evaluate the efficacy and safety of side-hole catheter technique for transarterial chemoembolization (TACE) via transradial artery access (TRA) in patients with hepatocellular carcinoma.
From November 2015 to August 2017, a total of 1040 TACE procedures were performed via TRA for hepatocellular carcinoma. In 10 (1%) of these 1040 TACE procedures via TRA, conventional microcatheter technique (CMT) failed and side-hole catheter technique was attempted.
Ten procedures of selective catheterizations by CMT failed due to the poor stability of the angiographic catheters or the target artery arising from the very proximal portion of the parent artery. These arteries included the right inferior phrenic artery in eight patients, one left gastric artery, and one right renal capsular artery. Cobra or MPA catheter with the microcatheter through the side-hole yielded a technical success rate of 100%. No procedure-related complications were observed. The mean time required to catheterize the target artery with the side-hole catheter was 9.5 min (5-15 min).
Side-hole catheter technique may enable the completion of chemoembolization in cases that a potential tumor-feeding vessel cannot be catheterized by means of CMT for TACE via TRA.
本研究旨在回顾性评估经桡动脉途径（TRA）行肝动脉化疗栓塞术（TACE）中使用侧孔导管技术治疗肝细胞癌的疗效和安全性。
2015 年 11 月至 2017 年 8 月，共对 1040 例肝细胞癌患者行 TRA 下 TACE 治疗。其中 10 例（1%）患者由于造影导管稳定性差或靶动脉起源于母动脉近端，行传统微导管技术（CMT）失败，尝试使用侧孔导管技术。
由于造影导管稳定性差或靶动脉起源于母动脉近端，CMT 选择性导管插入术失败 10 次，这些动脉包括 8 例患者的右膈下动脉、1 例左胃动脉和 1 例右肾包膜动脉。通过侧孔将 cobra 或 MPA 导管与微导管一起使用，技术成功率为 100%。无手术相关并发症。使用侧孔导管技术对靶动脉进行导管插入的平均时间为 9.5 分钟（5-15 分钟）。
在经 TRA 行 TACE 中，对于 CMT 无法导管插入的潜在肿瘤供养血管，侧孔导管技术可能使化疗栓塞术得以完成。
