Transradial versus transfemoral arterial access in Yttrium-90 microspheres radioembolization for hepatocellular carcinoma

OBJECTIVE: Transradial access has become more popular in body intervention procedures but has not been ubiquitously adapted. This study assesses the efficacy of this approach in Yttrium-90 labeled microspheres radioembolization. To compare transradial to transfemoral access in hepatocellular carcinoma patients who underwent Yttrium-90 radioembolization. MATERIALS AND METHODS: A total of 244 hepatocellular carcinoma patients underwent 337 radioembolization procedures at our institute from May 2014 to May 2020. The transradial access-group included 188 patients (252 procedures) while the transfemoral access group had 63 patients (85 procedures). The recovery time, fluoroscopy time, contrast volume, peak radiation dose, and equipment cost for each procedure were all reviewed to evaluate for statistical differences between the two groups. RESULTS: The transradial cohort recorded a significantly shorter (P < 0.01) mean recovery time (from the end of the procedure to discharge) and had a significantly shorter (P < 0.05) use of contrast volume versus the transfemoral group. In addition, the radiation dose and fluoroscopy time were lower in the transradial subset, although not statistically different. Furthermore, the overall cost for procedural equipment was significantly less (P < 0.01) in the transradial cohort than in the transfemoral. No major complications were reported in the transradial group, while one pseudoaneurysm was noted in the transfemoral group. CONCLUSION: With respect to many pertinent parameters, transradial access was evaluated as being more advantageous than transfemoral access. The results of this study suggest that transradial access should be considered more often, whenever feasible, as an option in the Yttrium-90 treatment of hepatocellular carcinoma patients.