Name: transradial access chemoembolization for hepatocellular carcinoma patients
Uploaded: 2020-09-20T13:00:00
Description: Watch this Scientific Journal Video about Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients at JoVE.com

Dette arbejde blev støttet af den særlige kliniske forskningsfond fra Zhongshan Hospital, Fudan University (2016ZSLC17). Forfatterne er meget taknemmelige for Dr. Xianglin Hu i Zhongshan Hospital i Fudan University for hans meget professionelle forslag til engelsk skrivning.

Denne retrospektive undersøgelse med et enkelt center blev godkendt af det lokale institutionelle review board på Zhongshan Hospital, Fudan University.
1. Opnåelse af informeret samtykke
<ol><li>Før TRA interventioner, har interventionelle radiologer (IRs) forklare fordele og potentielle komplikationer af TRA til patienterne.</li>
</ol>2. Patientevaluering
<ol><li>Når du har indhentet informeret samtykke, skal du vurdere raen for muligheden for...

<ol>
	<li>Yoon, S. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+Safety+of+Transarterial+Chemoembolization+Plus+External+Beam+Radiotherapy+vs+Sorafenib+in+Hepatocellular+Carcinoma+with+Macroscopic+Vascular+Invasion+A+Randomized+Clinical+Trial.">Efficacy and Safety of Transarterial Chemoembolization Plus External Beam Radiotherapy vs Sorafenib in Hepatocellular Carcinoma with Macroscopic Vascular Invasion A Randomized Clinical Trial.</a> JAMA Oncology. 4 (5), 661-669 (2018).</li><li>Global Burden of Disease. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Global+Burden+of+Cancer+2013.">The Global Burden of Cancer 2013.</a> JAMA Oncology. 1 (4), 505-527 (2015).</li><li>Iezzi, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+versus+Transfemoral+Access+for+Hepatic+Chemoembolization:+Intrapatient+Prospective+Single-Center+Study.">Transradial versus Transfemoral Access for Hepatic Chemoembolization: Intrapatient Prospective Single-Center Study.</a> Journal of Vascular and Interventional Radiology. 28 (9), 1234-1239 (2017).</li><li>Rao, S. V., Cohen, M. G., Kandzari, D. E., Bertrand, O. F., Gilchrist, I. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+transradial+approach+to+percutaneous+coronary+intervention:+historical+perspective,+current+concepts,+and+future+directions.">The transradial approach to percutaneous coronary intervention: historical perspective, current concepts, and future directions.</a> Journal of the American College of Cardiology. 55 (20), 2187-2195 (2010).</li><li>Hamon, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Consensus+document+on+the+radial+approach+in+percutaneous+cardiovascular+interventions:+position+paper+by+the+European+Association+of+Percutaneous+Cardiovascular+Interventions+and+Working+Groups+on+Acute+Cardiac+Care+and+Thrombosis+of+the+European+Society+of+Cardiology.">Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology.</a> EuroIntervention. 8 (11), 1242-1251 (2013).</li><li>Feldman, D. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adoption+of+radial+access+and+comparison+of+outcomes+to+femoral+access+in+percutaneous+coronary+intervention:+an+updated+report+from+the+national+cardiovascular+data+registry+(2007-2012).">Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012).</a> Circulation. 127 (23), 2295-2306 (2013).</li><li>Jolly, S. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radial+versus+femoral+access+for+coronary+angiography+and+intervention+in+patients+with+acute+coronary+syndromes+(RIVAL):+a+randomised,+parallel+group,+multicentre+trial.">Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial.</a> Lancet. 377 (9775), 1409-1420 (2011).</li><li>Valgimigli, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radial+versus+femoral+access+in+patients+with+acute+coronary+syndromes+undergoing+invasive+management:+a+randomised+multicentre+trial.">Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial.</a> Lancet. 385 (9986), 2465-2476 (2015).</li><li>Du, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+access+chemoembolization+for+hepatocellular+carcinoma+in+comparation+with+transfemoral+access.">Transradial access chemoembolization for hepatocellular carcinoma in comparation with transfemoral access.</a> Translational Cancer Research. 8 (5), 1795-1805 (2019).</li><li>Galyfos, G., Sigala, F., Filis, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+versus+Transfemoral+access+in+patients+undergoing+peripheral+artery+angioplasty/stenting:+A+meta-analysis.">Transradial versus Transfemoral access in patients undergoing peripheral artery angioplasty/stenting: A meta-analysis.</a> Cardiovascular Revascularization Medicine. 19 (4), 457-465 (2018).</li><li>Barbeau, G. R., Arsenault, F., Dugas, L., Simard, S., Lariviere, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+the+ulnopalmar+arterial+arches+with+pulse+oximetry+and+plethysmography:+comparison+with+the+Allen's+test+in+1010+patients.">Evaluation of the ulnopalmar arterial arches with pulse oximetry and plethysmography: comparison with the Allen's test in 1010 patients.</a> American Heart Journal. 147 (3), 489-493 (2004).</li><li>Kiemeneij, F., Laarman, G. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+transradial+artery+approach+for+coronary+Palmaz-Schatz+stent+implantation.">Percutaneous transradial artery approach for coronary Palmaz-Schatz stent implantation.</a> American Heart Journal. 128 (1), 167-174 (1994).</li><li>Achenbach, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+versus+transfemoral+approach+for+coronary+angiography+and+intervention+in+patients+above+75+years+of+age.">Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age.</a> Catheterization and Cardiovascular Interventions. 72 (5), 629-635 (2008).</li><li>Agostoni, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radial+versus+femoral+approach+for+percutaneous+coronary+diagnostic+and+interventional+procedures;+Systematic+overview+and+meta-analysis+of+randomized+trials.">Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials.</a> Journal of the American College of Cardiology. 44 (2), 349-356 (2004).</li><li>Caputo, R. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+cardiac+catheterization+in+elderly+patients.">Transradial cardiac catheterization in elderly patients.</a> Catheterization and Cardiovascular Interventions. 51 (3), 287-290 (2000).</li><li>Cox, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+the+risk+of+vascular+complications+associated+with+femoral+and+radial+access+coronary+catheterization+procedures+in+obese+versus+nonobese+patients.">Comparison of the risk of vascular complications associated with femoral and radial access coronary catheterization procedures in obese versus nonobese patients.</a> American Journal of Cardiology. 94 (9), 1174-1177 (2004).</li><li>Titano, J. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+and+Feasibility+of+Transradial+Access+for+Visceral+Interventions+in+Patients+with+Thrombocytopenia.">Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia.</a> Cardiovascular and Interventional Radiology. 39 (5), 676-682 (2016).</li><li>Mortensen, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prospective+Study+on+Total+Fluoroscopic+Time+in+Patients+Undergoing+Uterine+Artery+Embolization:+Comparing+Transradial+and+Transfemoral+Approaches.">Prospective Study on Total Fluoroscopic Time in Patients Undergoing Uterine Artery Embolization: Comparing Transradial and Transfemoral Approaches.</a> Cardiovascular and Interventional Radiology. 42 (3), 441-447 (2019).</li><li>Iezzi, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Operator+learning+curve+for+transradial+liver+cancer+embolization:+implications+for+the+initiation+of+a+transradial+access+program.">Operator learning curve for transradial liver cancer embolization: implications for the initiation of a transradial access program.</a> Diagnostic and Interventional Radiology. 25 (5), 368-374 (2019).</li><li>Mounsey, C. A., Mawhinney, J. A., Werner, R. S., Taggart, D. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Does+Previous+Transradial+Catheterization+Preclude+Use+of+the+Radial+Artery+as+a+Conduit+in+Coronary+Artery+Bypass+Surgery.">Does Previous Transradial Catheterization Preclude Use of the Radial Artery as a Conduit in Coronary Artery Bypass Surgery.</a> Circulation. 134 (9), 681-688 (2016).</li><li>Hibbert, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+versus+transfemoral+artery+approach+for+coronary+angiography+and+percutaneous+coronary+intervention+in+the+extremely+obese.">Transradial versus transfemoral artery approach for coronary angiography and percutaneous coronary intervention in the extremely obese.</a> JACC: Cardiovascular Interventions. 5 (8), 819-826 (2012).</li><li>Fischman, A. M., Swinburne, N. C., Patel, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Technical+Guide+Describing+the+Use+of+Transradial+Access+Technique+for+Endovascular+Interventions.">A Technical Guide Describing the Use of Transradial Access Technique for Endovascular Interventions.</a> Techniques in Vascular and Interventional Radiology. 18 (2), 58-65 (2015).</li><li>Caputo, R. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+arterial+access+for+coronary+and+peripheral+procedures:+executive+summary+by+the+Transradial+Committee+of+the+SCAI.">Transradial arterial access for coronary and peripheral procedures: executive summary by the Transradial Committee of the SCAI.</a> Catheterization and Cardiovascular Interventions. 78 (6), 823-839 (2011).</li><li>Shiozawa, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+approach+for+transcatheter+arterial+chemoembolization+in+patients+with+hepatocellular+carcinoma+-+Comparison+with+conventional+transfemoral+approach.">Transradial approach for transcatheter arterial chemoembolization in patients with hepatocellular carcinoma - Comparison with conventional transfemoral approach.</a> Journal of Clinical Gastroenterology. 37 (5), 412-417 (2003).</li><li>Mitchell, M. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systematic+review+and+cost-benefit+analysis+of+radial+artery+access+for+coronary+angiography+and+intervention.">Systematic review and cost-benefit analysis of radial artery access for coronary angiography and intervention.</a> Circulation: Cardiovascular Quality and Outcomes. 5 (4), 454-462 (2012).</li><li>Shoji, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stroke+After+Percutaneous+Coronary+Intervention+in+the+Era+of+Transradial+Intervention.">Stroke After Percutaneous Coronary Intervention in the Era of Transradial Intervention.</a> Circulation: Cardiovascular Interventions. 11 (12), 006761 (2018).</li><li>Jurga, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebral+microembolism+during+coronary+angiography:+a+randomized+comparison+between+femoral+and+radial+arterial+access.">Cerebral microembolism during coronary angiography: a randomized comparison between femoral and radial arterial access.</a> Stroke. 42 (5), 1475-1477 (2011).</li><li>Bishay, V. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transradial+Approach+for+Hepatic+Radioembolization:+Initial+Results+and+Technique.">Transradial Approach for Hepatic Radioembolization: Initial Results and Technique.</a> AJR: American Journal of Roentgenology. 207 (5), 1112-1121 (2016).</li><li>Bernat, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ST-segment+elevation+myocardial+infarction+treated+by+radial+or+femoral+approach+in+a+multicenter+randomized+clinical+trial:+the+STEMI-RADIAL+trial.">ST-segment elevation myocardial infarction treated by radial or femoral approach in a multicenter randomized clinical trial: the STEMI-RADIAL trial.</a> Journal of the American College of Cardiology. 63 (10), 964-972 (2014).</li></ol>

TRA interventionel behandling er vokset betydeligt på verdensplan i de senere år, især i diagnostiske og interventionelle kardiologiprocedurer12. Desuden har der været stigende opmærksomhed på perifere vaskulære sygdomme intervention. Uden at gå på kompromis proceduremæssige succesrater, TRA til hjerteintervention kan effektivt reducere antallet af blødninger og vaskulære komplikationer sammenlignet med TFA13,14. Sammenlignet m...

Hepatocellulær carcinom (HCC) er en meget almindelig malignitet, med den sjette højeste forekomst på verdensplan. Det er også den næststørste årsag til kræftdødelighed rundt om i verden1. Fordi kun 5%-20% af patienterne kan modtage helbredende behandling, transarterial kemoembolization (TACE) er den mest populære palliativ behandling for patienter med unresectable HCC2. TACE er blevet anerkendt som den mest anvendte og effektive behandlingsmetode for HCC-patienter på mellemstadiet3. Transfemoral adgang (TFA) kemoembolization er den mest almindelige metode for TACE4. Der er dog risici forbundet med TFA-intervention, herunder blødning på adgangsstedet og større vaskulære komplikationer5. Disse komplikationer fører til langvarig indlæggelse og øgede omkostninger. Desuden kræver TFA immobilisering i mindst 6 timer, hvilket øger ubehag og utilfredshed for patienterne.
Transradial access (TRA) er en alternativ tilgang , der har været anvendt i perkutan koronar intervention (PCI) i mere end to årtier5,6. TRA PCI har flere fordele: øget procedure komfort, nedsat adgang sted-relaterede blødninger, faldt store vaskulære komplikationer, og nedsatdødelighed 7,8. Den radiale arterie (RA) er let at få adgang til og punktere på grund af sin overfladiske placering7. Hemostasis er let at gennemføre efter intervention, og der er ingen streng immoblization9. På trods af opmuntrende beviser for TRA intervention i hjertekateterisering, til dato kun et par undersøgelser, der anvendes TRA i perifer sygdom intervention. TRA interventioner for ondartede levertumorer er endnu sjældnere. Her analyseres den kliniske gennemførlighed og sikkerhed af TRA-hepatisk embolisering. En institutions erfaring med den trinvise TRA-protokol, der leveres, er også beskrevet.

<table border="0" cellpadding="0" cellspacing="0" style="width:553px;" width="553">
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	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Reagents</td>
			<td style="width:127px;"></td>
			<td style="width:123px;"></td>
			<td style="width:163px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Embosphere</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">20173776165</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Gelfoam</td>
			<td style="width:127px;">Alicon</td>
			<td style="width:123px;">20143771056</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Heparin</td>
			<td style="width:127px;">Hepatunn</td>
			<td style="width:123px;">H51021209</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Injection syringe</td>
			<td style="width:127px;">KDL</td>
			<td style="width:123px;">20163150518</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Iodinated oil</td>
			<td style="width:127px;">Yantai Luyin Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H37022398</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Lidocaine</td>
			<td style="width:127px;">Shandong Hualu Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H37022147</td>
			<td></td>
		</tr>
		<tr height="84">
			<td height="84" style="height:84px;width:141px;">Lobaplatin</td>
			<td style="width:127px;">Hainan Changan International Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H20050308</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Nitroglycerin</td>
			<td style="width:127px;">Brijing Yimin Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H11020289</td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:141px;">Normal saline</td>
			<td style="width:127px;">Anhui Shuanghe Pharmaceutical Co.Ltd</td>
			<td style="width:123px;">H34023609</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Pharmorubicin</td>
			<td style="width:127px;">Pfizer</td>
			<td style="width:123px;">H20000496</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Ultravist 370</td>
			<td style="width:127px;">Bayer</td>
			<td style="width:123px;">H20171333</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Material</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:141px;">Hydrophilic Guide Wire</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">LWSTDA38180</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Injection syringe</td>
			<td style="width:127px;">KDL</td>
			<td style="width:123px;">20163150518</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:141px;">Maestro Microcatheter</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">28MC24150SN</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">MPA1 (I) catheter</td>
			<td style="width:127px;">Cordis</td>
			<td style="width:123px;">451-406P0</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Sheath Introducer</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">PSI-4F-11-035</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Steerable Guidewire</td>
			<td style="width:127px;">Merit</td>
			<td style="width:123px;">TNR2411</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">TR Band</td>
			<td style="width:127px;">Terumo</td>
			<td style="width:123px;">XX*RF06</td>
			<td></td>
		</tr>
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			<td height="21" style="height:21px;width:141px;">Equipment</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">DSA</td>
			<td style="width:127px;">Toshiba</td>
			<td style="width:123px;">INFX-9000V</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:141px;">Ultrasonic machine</td>
			<td style="width:127px;">SonoScape</td>
			<td style="width:123px;">20172231180</td>
			<td></td>
		</tr>
	</tbody>
</table>

transradial access chemoembolization for hepatocellular carcinoma patients

Transarterial kemoembolisering (TACE) er den mest almindelige modalitet til behandling af hepatocellulær carcinom (HCC) på mellemstadiet. TACE udføres typisk via transfemoral adgang (TFA). Transradial access (TRA) foretrækkes dog i koronararterieinterventioner på grund af nedsat komplikationer og dødelighed. Om fordelene ved TRA kan anvendes på TACE krævede undersøgelse.
Patienter, der fik TRA TACE på et enkelt center, blev retrospektivt indskrevet til undersøgelse. Proceduremæssige detaljer, teknisk succes, radial arterie okklusion (RAO) sats, og adgang site-relaterede blødning komplikationer blev evalueret. Fra oktober 2017 til oktober 2018 gennemgik 112 patienter 160 TRA TACE-procedurer. Den samlede tekniske succesrate var 95,0% (152/160). Satsen for crossover fra TRA til TFA var 1,9%. Ingen adgang site-relaterede blødning komplikationer blev fundet i nogen tilfælde. Asymptomatisk RA okklusion forekom hos tre patienter (2,7%). Sammenlignet med TFA kan TRA øge sikkerheden og patienttilfredsheden og samtidig mindske de adgangsstedsrelaterede blødningskomplikationer. Desuden kan TRA-interventioner gavne patienter med fremskreden alder, fedme eller en høj risiko for blødningskomplikationer.

Fra oktober 2017 til oktober 2018 gennemgik 112 patienter 160 TRA TACE-procedurer, og den samlede tekniske succesrate var 95,0% (152/160). Otte sager blev mødt med tekniske fejl. Af disse var fem tilfælde forårsaget af venstre RA punktering fiasko og efterfølgende gennemgik en vellykket TACE med højre RA adgang. De tre andre tilfælde var forårsaget af cannulation fiasko, og gennemgik efterfølgende vellykket intervention ved crossover til højre FA adgang. Crossover-satsen for RA-adgang til FA-adgang var kun 1,9%....

Watch this Scientific Journal Video about Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients at JoVE.com

Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

Transarterial kemoembolization (TACE) er standardbehandling for patienter i den mellemliggende fase af hepatocellulær carcinom og udføres typisk gennem femoral arterieadgang. Sammenlignet med transfemoral adgang, transradial adgang (TRA) kan reducere antallet af blødning komplikationer og forbedre patientens tolerance. En metode præsenteres her for at udføre transarterial kemoembolisering via radial arterieadgang.

Transradial Adgang Chemoembolization for Hepatocellulære Carcinoma Patienter

Transarterial chemoembolization (TACE) is the most common modality for treatment of hepatocellular carcinoma (HCC) at the intermediate stage. TACE is ...

Research

JoVE Journal

Cancer Research

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