Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Eur Radiol. 2022 Oct;32(10):6812-6819. doi: 10.1007/s00330-022-09038-1. Epub 2022 Aug 26.
To compare patient satisfaction, procedural variables, and safety with transradial access (TRA) and transfemoral access (TFA) in patients undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
From February 2019 to August 2021, 130 patients undergoing TACE for HCC were randomly allocated to the TRA (n = 65) or TFA (n = 65) group. Vascular closure devices were not used after TFA-TACE. All patients completed the post-catheterization questionnaire and 8-item Short-Form Health Survey 1 day after TACE.
Technical success rate, crossover rate, contrast agent dose, fluoroscopy time, procedure time, air kerma, dose-area product, length of hospital stay, and total cost were similar between the two groups (all p > 0.05). The incidence and severity of adverse events were also similar between the two groups (all p > 0.05). However, overall discomfort, difficulty going to the bathroom, difficulty feeding or self-caring, difficulty walking, general health, physical function, role physical function, social function, mental health, and role emotional function were better in the TRA group than in the TFA group (all p < 0.001). Consequently, more patients preferred the current access for their next procedure in the TRA group than in the TFA group (90.8% vs. 24.6%; p < 0.001).
In patients undergoing TACE for HCC, using TRA instead of TFA can improve patient satisfaction without compromising procedural variables and safety.
• Transradial access (TRA) enabled early ambulation after transarterial chemoembolization (TACE), resulting in significant increase in activities of daily living and health-related quality of life (HRQoL) compared to transfemoral access (TFA) when vascular closure devices were not used. • Procedural variables (contrast agent dose, fluoroscopy time, procedure time, air kerma, dose-area product, length of hospital stay, and total cost) were not significantly different between patients who received TRA-TACE and TFA-TACE. • The incidence and severity of adverse events were similar between patients who received TRA-TACE and TFA-TACE.
比较经桡动脉入路（TRA）和经股动脉入路（TFA）在接受经动脉化疗栓塞术（TACE）治疗肝细胞癌（HCC）患者中的患者满意度、手术变量和安全性。
2019 年 2 月至 2021 年 8 月，130 例接受 HCC 患者 TACE 的患者被随机分为 TRA（n=65）或 TFA（n=65）组。TFA-TACE 后不使用血管闭合装置。所有患者在 TACE 后 1 天完成导管后问卷和 8 项简短健康调查。
两组的技术成功率、交叉率、对比剂剂量、透视时间、手术时间、空气比释动能、剂量面积乘积、住院时间和总费用均相似（均 P＞0.05）。两组的不良事件发生率和严重程度也相似（均 P＞0.05）。然而，TRA 组的整体不适、如厕困难、进食或自理困难、行走困难、一般健康状况、身体功能、角色身体功能、社会功能、心理健康和角色情绪功能均优于 TFA 组（均 P＜0.001）。因此，TRA 组的患者更倾向于在下次治疗中选择当前入路，而 TFA 组的患者则不然（90.8%比 24.6%；P＜0.001）。
在接受 HCC 患者 TACE 的患者中，与 TFA 相比，使用 TRA 可以在不影响手术变量和安全性的情况下提高患者满意度。
• 与未使用血管闭合装置时的经股动脉入路（TFA）相比，经桡动脉入路（TRA）允许 TACE 后早期活动，从而显著提高日常生活活动和健康相关生活质量（HRQoL）。• 接受 TRA-TACE 和 TFA-TACE 的患者之间，手术变量（对比剂剂量、透视时间、手术时间、空气比释动能、剂量面积乘积、住院时间和总费用）无显著差异。• 接受 TRA-TACE 和 TFA-TACE 的患者之间的不良事件发生率和严重程度相似。
