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经桡动脉与股动脉入路行肝动脉化疗栓塞术治疗肝细胞癌的比较。

Comparison Between Radial and Femoral Artery Access for Transarterial Chemoembolisation in Patients With Hepatocellular Carcinoma.

机构信息

Department of Radiology, Hopital Cochin, AP-HP, Paris, France.

Faculté de Médecine, Université Paris Cité, Paris, France.

出版信息

Can Assoc Radiol J. 2024 Feb;75(1):178-186. doi: 10.1177/08465371231186524. Epub 2023 Aug 10.

Abstract

PURPOSE

The purpose of this study was to compare the technical success rate, the selectivity of transarterial chemoembolisation (TACE), the complication rate, the radiation dose given to the patients and the hospitalization stay between TACE performed using femoral artery approach (FAA) and TACE performed using radial artery approach (RAA) in patients with hepatocellular carcinoma (HCC).

METHODS

Between June 2020 and April 2022, 49 patients with HCC who underwent 116 TACEs (75 using FAA and 41 using RAA) were included. Differences in technical success rate, selectivity of micro-catheterization, radiation dose given to the patients, fluoroscopy time, hospitalization stay duration, and complication rate were compared between FAA and RAA using Fisher exact or Student tests.

RESULTS

No differences in technical success rates were found between RAA (93%; 39/41 TACEs) and FAA (100%; 75/75 TACEs) ( = .12). There were no differences between the two groups in terms of selectivity of catheterization, radiation dose, fluoroscopy time and hospitalization stay duration. Five patients had Grade 2 complications (hematoma) after FAA vs. one patient with one Grade 1 complication (radial artery occlusion) after RAA (5/75 [7%] vs. 1/41 [2%], respectively; = .42). No major arterial access site complications occurred with FAA or RAA.

CONCLUSIONS

This study confirms that RAA is a safe approach that does not compromise the technical efficacy and the selectivity of TACE compared to FAA in patients with HCC.

摘要

目的

本研究旨在比较经股动脉途径(FAA)和经桡动脉途径(RAA)行肝动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)患者的技术成功率、选择性、并发症发生率、患者接受的辐射剂量和住院时间。

方法

2020 年 6 月至 2022 年 4 月,共纳入 49 例 HCC 患者,共行 116 次 TACE(75 次采用 FAA,41 次采用 RAA)。采用 Fisher 确切检验或 Student t 检验比较 FAA 和 RAA 组间技术成功率、微导管选择性、患者接受的辐射剂量、透视时间、住院时间和并发症发生率的差异。

结果

RAA 组(93%,39/41 次 TACE)和 FAA 组(100%,75/75 次 TACE)的技术成功率无差异( =.12)。两组间的导管选择性、辐射剂量、透视时间和住院时间无差异。FAA 组 5 例(7%)发生 2 级并发症(血肿),RAA 组 1 例(2%)发生 1 级并发症(桡动脉闭塞)(5/75 [7%] vs. 1/41 [2%], =.42)。FAA 或 RAA 均未发生主要动脉入路部位并发症。

结论

本研究证实,与 FAA 相比,RAA 是一种安全的方法,在 HCC 患者中不影响 TACE 的技术疗效和选择性。

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