Modified Patent Hemostasis Strategy Based on the Platelet Counts for Transradial Access Chemoembolization in Patients with Hepatocellular Carcinoma: A Prospective Single-Center Study

Abstract

Yin-Gen Luo, Xiao-Wu Zhang, Jiay-Wei Tsauo, Ying Li, Jin-Gui Li, Qing Peng, Ya-Wei Li, Wei Sun, He Zhao, Xiao Li Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Xiao Li; He Zhao, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China, Tel/Fax [phone], Email [email protected]; [email protected]: This study aimed to investigate the shortest compression time to achieve hemostasis and the optimal hemostasis strategy in patients treated with transradial access chemoembolization (TRA-TACE).Methods: From October 2019 to October 2021, 119 consecutive patients with hepatocellular carcinoma (HCC) who underwent 134 sessions of TRA-TACE were included in this prospective single-center study. The compression time was measured by decompressing the device for 30 min, and thereafter, every 10 min after the procedure until complete hemostasis was achieved.Results: Technical success was achieved for all TRA procedures. None of the patients experienced major TRA-related adverse events. Minor adverse events occurred in 7.5% of the patients. The mean compression time was 31.8 ± 5.0 min. Factors that may impact hemostasis were analyzed by univariate and multivariate analyses, and a platelet count < 100× 109 /L (p = 0.016, odds ratio = 3.942) was found to be an independent factor that could predict the failure to achieve hemostasis within 30 min. For patients with a platelet count < 100× 109 /L, the compression time required to achieve hemostasis was 60 min. For patients with a platelet count ≥ 100× 109 /L, the compression time required to achieve hemostasis was 40 min.Conclusion: To achieve hemostasis in patients with HCC treated with TRA-TACE, compression for 60 min is sufficient for those with a platelet count < 100× 109 /L, and compression for 40 min is sufficient for those with a platelet count ≥ 100× 109 /L.Keywords: hepatocellular carcinoma, transarterial chemoembolization, transradial access, hemostasis

Keywords

• carcinoma
• hepatocellular
• chemoembolization
• therapeutic
• hemostasis
• vascular access.