Retrospective cohort study of transarterial chemoembolization for hepatic malignant tumors via transradial and transfemoral access

doi:10.3877/cma.j.issn.2095-5782.2025.03.005

Abstract

Abstract:

Objective

To evaluate the safety and the short-term effect of TACE in treating hepatic malignant tumor via TRA and TFA.

Methods

This retrospective study analyzed 43 patients with hepatic malignancies treated at the authors' institutions between October 2021 and December 2023. All patients underwent TRA TACE following prior TFA TACE. The primary endpoints were the technical success, the complications and the adverse events. The secondary endpoints were the short-term effect and the dose-related indexes.

Results

Radial artery and target vessel catheterization were successfully performed in 42 cases in the TRA group, of which the technical success rate was 97.7%. The technical success rate of the TFA group was 100%, and the difference between the two group was not significant (P>0.05). The incidence of the complications and the adverse events in the TRA group and the TFA group were 2.3%vs.9.3% and 79.1%vs.74.4%, respectively, with no significant difference (P>0.05). The fluoroscopy time, the accumulative dose, and the dose area product in the TRA group and the TFA group were 12(10, 15) min vs. 10(8, 12) min; 567(412, 760) mGy vs. 481(390, 670) mGy; 191(152, 288) Gy×cm²vs. 188(141, 220) Gy×cm², respectively. The difference of the fluoroscopy time between the two groups was significant(P<0.001). The short-term effect of the two groups was comparable, with no significant difference(P>0.05).

Conclusion

The safety and the short-term effect of TRA TACE in treating hepatic malignant tumor are comparable to TFA TACE. Although TRA TACE may increase the fluoroscopy time, it may not increase the radiation dose.

Key words: Transarterial chemoembolization, Hepatic malignant tumor, Transradial access, Transfemoral access

Na LIU, Chang-hui YU, Bo PENG, Hong-jian SHI, Zhen GAN. Retrospective cohort study of transarterial chemoembolization for hepatic malignant tumors via transradial and transfemoral access[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2025, 13(03): 222-227.

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Figures/Tables 5

组别	例数	男性 [例(%)]	年龄 (年, $x ¯ ± s$ )	病理类型 [例(%)]			治疗间隔(个月, $x ¯ ± s$ )	ECOG-PS评分[例(%)]			Child-Pugh评分 [例(%)]				ALBI分级 [例(%)]
组别	例数	男性 [例(%)]	年龄 (年, $x ¯ ± s$ )	HCC	ICC	MHC	治疗间隔(个月, $x ¯ ± s$ )	0分	1分	2分	5分	6分	7分	8分	1级	2级
TRA组	43	38 (88.4)	65.3±10.7	29 (67.4)	2 (4.7)	12 (27.9)	4.0±2.9	11 (25.6)	31 (72.1)	1 (2.3)	33 (76.7)	7 (16.3)	2 (4.7)	1 (2.3)	30 (69.8)	13 (30.2)
TFA组	43	38 (88.4)	65.3±10.7	29 (67.4)	2 (4.7)	12 (27.9)	4.0±2.9	11 (25.6)	28 (65.1)	4 (9.3)	30 (69.8)	9 (20.9)	4 (9.3)	0 (0.0)	28 (65.1)	15 (34.9)
P值								0.496			0.795				0.818

组别	例数	男性 [例(%)]	年龄 (年, $x ¯ ± s$ )	病理类型 [例(%)]			治疗间隔(个月, $x ¯ ± s$ )	ECOG-PS评分[例(%)]			Child-Pugh评分 [例(%)]				ALBI分级 [例(%)]
组别	例数	男性 [例(%)]	年龄 (年, $x ¯ ± s$ )	HCC	ICC	MHC	治疗间隔(个月, $x ¯ ± s$ )	0分	1分	2分	5分	6分	7分	8分	1级	2级
TRA组	43	38 (88.4)	65.3±10.7	29 (67.4)	2 (4.7)	12 (27.9)	4.0±2.9	11 (25.6)	31 (72.1)	1 (2.3)	33 (76.7)	7 (16.3)	2 (4.7)	1 (2.3)	30 (69.8)	13 (30.2)
TFA组	43	38 (88.4)	65.3±10.7	29 (67.4)	2 (4.7)	12 (27.9)	4.0±2.9	11 (25.6)	28 (65.1)	4 (9.3)	30 (69.8)	9 (20.9)	4 (9.3)	0 (0.0)	28 (65.1)	15 (34.9)
P值								0.496			0.795				0.818

组别	例数	技术成功[例(%)]	介入手术相关并发症[例(%)]				CIRSE分级[例(%)]		介入治疗不良反应[例(%)]							3级不良反应[例(%)]
组别	例数	技术成功[例(%)]	穿刺部位血肿	假性动脉瘤	动脉闭塞	合计	1级	2或3级	疲乏	发热	恶心呕吐	腹痛	便秘	骨髓抑制	合计	3级不良反应[例(%)]
TRA组	43	42 (97.7)	0 (0.0)	0 (0.0)	1 (2.3)	1 (2.3)	0 (0.0)	1 (2.3)	16 (37.2)	18 (41.9)	15 (34.9)	24 (55.8)	3 (7.0)	6 (14.0)	34 (79.1)	3 (7.0)
TFA组	43	43 (100.0)	3 (7.0)	1 (2.3)	0 (0.0)	4 (9.3)	3 (7.0)	1 (2.3)	18 (41.9)	15 (34.9)	14 (32.6)	20 (46.5)	5 (11.6)	5 (11.6)	32 (74.4)	2 (4.7)
P值		0.999	0.357				0.400		0.659	0.506	0.820	0.388	0.458	0.747	0.610	0.645

组别	例数	透视时间[min, M(Q₁，Q₃)]	累积剂量[mGy, M(Q₁，Q₃)]	剂量面积[Gy·cm², M(Q₁，Q₃)]	碘化油用量[mL, M(Q₁，Q₃)]	肝内病灶疗效评估 [例(%)]		住院时间[d, M(Q₁，Q₃)]	住院费用 (万元, $x ¯ ± s$ )
组别	例数	透视时间[min, M(Q₁，Q₃)]	累积剂量[mGy, M(Q₁，Q₃)]	剂量面积[Gy·cm², M(Q₁，Q₃)]	碘化油用量[mL, M(Q₁，Q₃)]	ORR	DCR	住院时间[d, M(Q₁，Q₃)]	住院费用 (万元, $x ¯ ± s$ )
TRA组	43	12 (10, 15)	567 (412, 760)	191 (152, 288)	4 (3, 6)	19 (44.2)	32 (74.4)	9 (7, 11)	2.8 ± 0.8
TFA组	43	10 (8, 12)	481 (390, 670)	188 (141, 220)	5 (2.5, 6)	22 (51.2)	33 (76.7)	8 (7, 11)	2.7 ± 0.7
P值		<0.001	0.063	0.279	0.901	0.517	0.802	0.490	0.629

组别	例数	透视时间[min, M(Q₁，Q₃)]	累积剂量[mGy, M(Q₁，Q₃)]	剂量面积[Gy·cm², M(Q₁，Q₃)]	碘化油用量[mL, M(Q₁，Q₃)]	肝内病灶疗效评估 [例(%)]		住院时间[d, M(Q₁，Q₃)]	住院费用 (万元, $x ¯ ± s$ )
组别	例数	透视时间[min, M(Q₁，Q₃)]	累积剂量[mGy, M(Q₁，Q₃)]	剂量面积[Gy·cm², M(Q₁，Q₃)]	碘化油用量[mL, M(Q₁，Q₃)]	ORR	DCR	住院时间[d, M(Q₁，Q₃)]	住院费用 (万元, $x ¯ ± s$ )
TRA组	43	12 (10, 15)	567 (412, 760)	191 (152, 288)	4 (3, 6)	19 (44.2)	32 (74.4)	9 (7, 11)	2.8 ± 0.8
TFA组	43	10 (8, 12)	481 (390, 670)	188 (141, 220)	5 (2.5, 6)	22 (51.2)	33 (76.7)	8 (7, 11)	2.7 ± 0.7
P值		<0.001	0.063	0.279	0.901	0.517	0.802	0.490	0.629

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