Application of transradial and transfemoral accesses during hepatic artery chemoembolization in the treatment of patients with malignant liver neoplasms

Abstract

Introduction Malignant neoplasms of the liver are one of the most common pathologies in oncology. Chemoembolization of the hepatic artery is currently widely used in the treatment of unresectable liver tumors. Transradial vascular access is actively used in interventional cardiology due to fewer local vascular complications. At the same time, until recently, chemoembolization of the hepatic artery was more often performed via transfemoral vascular access.The aim of the work is a comparative analysis of the results of transradial and transfemoral vascular accesses for the purpose of hepatic artery chemoembolization.Material and methods The data of 69 patients who underwent 212 hepatic artery chemoembolization procedures for malignant neoplasms in the liver were analyzed. The group of transradial access included 107 (50.5 %) interventions, the group of transfemoral access – 105 (49.5 %). The groups were comparable in terms of the main initial clinical and anamnestic data.Results Chemoembolization of the hepatic artery was successfully performed in 98.1 % in the transradial access group and 99 % in the transfemoral access group (p = 1.0). The total duration of intervention, time spent on catheterization of the target artery and radiation exposure were significantly shorter in the transradial access group than in the opposite group. The incidence of local vascular complications was not significantly different between the groups: 11 (10.3 %) and 12 (11.4 %) cases, respectively (p = 0.79). According to the results of patient interviews, the use of transradial access was accompanied by significantly less discomfort associated with the procedure.Discussion Traditionally, embolization of peripheral arteries is performed via transfemoral access, and the total incidence of local vascular complications (large subcutaneous hematomas, false aneurysms, arterovenous fistulas, etc.) is relatively high. According to the results of studies, it is possible to reduce the incidence of local vascular complications without increasing the cost of the procedure by performing the same interventions using transradial access.Conclusion Transradial vascular access has a number of significant advantages over transfemoral access, and therefore can be recommended as a priority for performing hepatic artery chemoembolization.