Roberto Iezzi1, Maurizio Pompili2, Alessandro Posa3, Eleonora Annicchiarico2, Matteo Garcovich2, Biagio Merlino3, Elena Rodolfino3, Vincenzo Di Noia4, Michele Basso4, Alessandra Cassano5, Carlo Barone4, Antonio Gasbarrini2, Riccardo Manfredi3, Cesare Colosimo3. 1. Department of Radiological Sciences, Policlinico Gemelli Foundation, Catholic University, l.go A. Gemelli 8, Rome 00168, Italy. Electronic address: roberto.iezzi.md@gmail.com. 2. Department of Gastroenterology, Policlinico Gemelli Foundation, Catholic University, l.go A. Gemelli 8, Rome 00168, Italy. 3. Department of Radiological Sciences, Policlinico Gemelli Foundation, Catholic University, l.go A. Gemelli 8, Rome 00168, Italy. 4. Department of Oncology, Policlinico Gemelli Foundation, Catholic University, l.go A. Gemelli 8, Rome 00168, Italy. 5. Department of Gastroenterology, Policlinico Gemelli Foundation, Catholic University, l.go A. Gemelli 8, Rome 00168, Italy; Department of Oncology, Policlinico Gemelli Foundation, Catholic University, l.go A. Gemelli 8, Rome 00168, Italy.
Abstract
PURPOSE: To compare transfemoral approach (TFA) and transradial approach (TRA) in patients undergoing hepatic chemoembolization in terms of safety, feasibility, and procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), and patient preference. MATERIALS AND METHODS: A single-center prospective intrapatient comparative study was conducted with 42 consecutive patients with hepatic malignancies who received 2 consecutive treatment sessions of unilobar hepatic chemoembolization within a 4-week interval over a 6-month period with both TRA and TFA. All procedures were performed by 1 interventional radiologist who assessed the eligibility of patients for inclusion in the study. The primary endpoint was intraprocedural conversion rate. Secondary endpoints were access site complications, angiographic and procedural variables, and evaluation of patient discomfort and preferences. RESULTS: A 100% technical success rate and a crossover rate of 0% were recorded. There were no major vascular complications and similar rates of minor complications (4.8% for TRA, 7.1% for TFA; P = .095), which were self-limited and without any clinical sequelae. TRA treatments required a significantly longer preparation time for the procedure (P = .008) with no significant differences for other procedural variables. Greater discomfort at the access route and patient inability to perform basic activities after the procedure were recorded for TFA (P < .001). TRA was preferred by 35 patients (35/42) for potential future transarterial procedures. CONCLUSIONS: TRA is safe and feasible for transarterial hepatic chemoembolization, with high technical success, low overall complications, and improved patient comfort.
PURPOSE: To compare transfemoral approach (TFA) and transradial approach (TRA) in patients undergoing hepatic chemoembolization in terms of safety, feasibility, and procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), and patient preference. MATERIALS AND METHODS: A single-center prospective intrapatient comparative study was conducted with 42 consecutive patients with hepatic malignancies who received 2 consecutive treatment sessions of unilobar hepatic chemoembolization within a 4-week interval over a 6-month period with both TRA and TFA. All procedures were performed by 1 interventional radiologist who assessed the eligibility of patients for inclusion in the study. The primary endpoint was intraprocedural conversion rate. Secondary endpoints were access site complications, angiographic and procedural variables, and evaluation of patient discomfort and preferences. RESULTS: A 100% technical success rate and a crossover rate of 0% were recorded. There were no major vascular complications and similar rates of minor complications (4.8% for TRA, 7.1% for TFA; P = .095), which were self-limited and without any clinical sequelae. TRA treatments required a significantly longer preparation time for the procedure (P = .008) with no significant differences for other procedural variables. Greater discomfort at the access route and patient inability to perform basic activities after the procedure were recorded for TFA (P < .001). TRA was preferred by 35 patients (35/42) for potential future transarterial procedures. CONCLUSIONS:TRA is safe and feasible for transarterial hepatic chemoembolization, with high technical success, low overall complications, and improved patient comfort.
Authors: Antonio Basile; Alberto Rebonato; Giovanni Failla; Giuseppe Caltabiano; Andrea Boncoraglio; Cecilia Gozzo; Alessandro Motta; Pietro Valerio Foti; Stefano Palmucci; Alfonso Juanjo García; Josè Garcia-Medina Journal: Radiol Med Date: 2018-07-17 Impact factor: 3.469
Authors: Louis-Xavier Barrette; Ansar Z Vance; Susan Shamimi-Noori; Gregory P Nadolski; Shilpa Reddy; Kathleen M Kratz; Jonas W Redmond; Timothy W I Clark Journal: Cardiovasc Intervent Radiol Date: 2020-02-10 Impact factor: 2.740