The comparative analysis of transradial and transfemoral vascular approaches for chemoembolization of pancreatic cancer

BACKGROUND: Pancreatic cancer is one of the most aggressive malignant neoplasms, and the results of treatment of which remain extremely unsatisfactory. One of the methods to increase the effectiveness of surgical treatment of pancreatic cancer is selective oil chemoembolization of the pancreatic arteries. Transfemoral access is typically used as a vascular access during this type of intervention, in which complications from the vascular access are often observed.

AIM: This study aimed to analyze the results of the use of transradial and transfemoral approaches for chemoembolization of pancreatic cancer.

MATERIALS AND METHODS: We analyzed the results of chemoembolization of pancreatic arteries in 32 patients with pancreatic cancer. Transfemoral access was used in 16 (50%) patients and transradial access in 16 (50%) patients. According to the main clinical and anamnestic data, both groups were comparable. The endpoints of the study were technical success and complication rate of chemoembolization, total duration of the procedure, time needed for catheterization of the target artery, radiation exposure, and degree of discomfort for the patient.

RESULTS: Chemoembolization of pancreatic arteries was successfully performed in 100% of patients in both groups. Major vascular complications were observed in three (18.8%) patients in the transfemoral access group and in one (6.3%) in the transradial access group (p=0.6). The total duration of the procedure and the time needed for catheterization of the target artery were 54.54±6.61 and 51.30±6.46 min (p=0.17) and 12.7 and 13.25 min (p=0.72), respectively. Radiation exposure was 0.68±0.10 mSv in the transfemoral access group and 0.65±0.10 mSv in the transradial access group (р=0.4). Transradial access was associated with a statistically significant reduction in all parameters of procedural discomfort.

CONCLUSION: In terms of efficiency and safety of use, the transradial approach is not inferior to the traditional transfemoral approach, and in terms of patient comfort, it can be recommended as a priority for chemoembolization of the pancreatic arteries.