Toyoda Hidenori, Yasuda Satoshi, Shiota Shohei, Chatani Shohei, Tsukii Ryota, Kitagawa Hirofumi, Fukushima Tomohisa, Urasaki Shohei, Kumada Takashi
Department of Gastroenterology Ogaki Municipal Hospital Ogaki Japan.
Department of Radiological Diagnosis and Interventional Radiology Aichi Cancer Center Hospital Nagoya Japan.
JGH Open. 2021 Jul 30;5(9):1041-1046. doi: 10.1002/jgh3.12628. eCollection 2021 Sep.
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.
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.
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.
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.
诸如经动脉化疗栓塞术（TACE）等肝脏血管造影术是治疗肝细胞癌（HCC）患者的重要手段，通常经股动脉途径进行。然而，经股动脉途径会给患者带来不适，且可能与穿刺部位血肿或假性动脉瘤的风险相关。我们评估了经桡动脉途径进行肝脏血管造影术的安全性、可行性及患者舒适度。
在这项单中心、回顾性、时间框架研究中，将2017年10月首次在我院采用经桡动脉途径进行肝脏血管造影术的206例患者，与在此之前采用经股动脉途径进行相同手术的240例患者进行比较。评估了多项指标，包括手术时间和安全性。此外，采用问卷调查来比较两种途径与手术相关的不适情况。
包括TACE在内的经桡动脉途径肝脏血管造影术在所有患者中均顺利完成，无并发症发生。桡动脉途径与股动脉途径的手术时间相当。大多数患者更喜欢经桡动脉途径而非股动脉途径。服用抗凝剂的患者能够在不停用这些药物的情况下完成手术。
经桡动脉途径的肝脏血管造影术比经股动脉途径带来的不适更少，且两种方法显示出相似的可行性和安全性。桡动脉途径可作为肝脏血管造影术的常规技术引入。
