Du Nan, Ma Jingqin, Yang Minjie, Zhang Zihan, Zheng Zhiyuan, Zhang Wen, Yan Zhiping
Department of Interventional Radiology, Zhongshan Hospital, Fudan University; Shanghai Institution of Medical Imaging.
Department of Interventional Radiology, Zhongshan Hospital, Fudan University; Shanghai Institution of Medical Imaging;
J Vis Exp. 2020 Sep 20(163). doi: 10.3791/61109.
Transarterial chemoembolization (TACE) is the most common modality for treatment of hepatocellular carcinoma (HCC) at the intermediate stage. TACE is typically performed via transfemoral access (TFA). However, transradial access (TRA) is preferred in coronary artery interventions due to decreased complications and mortality. Whether the advantages of TRA can be applied to TACE required investigation. Patients receiving TRA TACE at a single center were retrospectively enrolled for study. Procedural details, technical success, radial artery occlusion (RAO) rate, and access site-related bleeding complications were evaluated. From October 2017 to October 2018, 112 patients underwent 160 TRA TACE procedures. The overall technical success rate was 95.0% (152/160). The rate of crossover from TRA to TFA was 1.9%. No access site-related bleeding complications were found in any cases. Asymptomatic RA occlusion occurred in three patients (2.7%). Compared with TFA, TRA can increase safety and patient satisfaction while decreasing access site-related bleeding complications. Moreover, TRA interventions can benefit patients with advanced age, obesity, or a high risk of bleeding complications.
经动脉化疗栓塞术（TACE）是治疗中期肝细胞癌（HCC）最常用的方法。TACE通常经股动脉入路（TFA）进行。然而，由于并发症和死亡率降低，经桡动脉入路（TRA）在冠状动脉介入治疗中更受青睐。TRA的优势是否可应用于TACE尚需研究。对在单一中心接受TRA TACE的患者进行回顾性纳入研究。评估手术细节、技术成功率、桡动脉闭塞（RAO）率和与穿刺部位相关的出血并发症。2017年10月至2018年10月，112例患者接受了160次TRA TACE手术。总体技术成功率为95.0%（152/160）。从TRA转为TFA的发生率为1.9%。所有病例均未发现与穿刺部位相关的出血并发症。3例患者（2.7%）出现无症状RA闭塞。与TFA相比，TRA可提高安全性和患者满意度，同时减少与穿刺部位相关的出血并发症。此外，TRA干预对老年、肥胖或有出血并发症高风险的患者有益。
