Transradial Versus Transfemoral Arterial Access in Liver Cancer Embolization: Randomized Trial to Assess Patient Satisfaction

Purpose: To determine whether transradial access (TRA) or transfemoral access (TFA) provides better patient satisfaction during intraarterial therapy (IAT) for liver cancer. Materials and Methods: This randomized, prospective, intra- and interpatient controlled trial compared TRA vs TFA accesses in patients with primary or metastatic liver cancer undergoing IAT. After having one of each type of access (1 TRA and 1 TFA), all patients selected their preferred access regardless of whether a third intervention was indicated. The primary endpoint was patient access preference; secondary endpoints were access-related complications, procedure time, contrast agent volume, and radiation doses to the patient and operator. Patients were evaluated on postprocedure days 1 and 30. Results: Fifty-five patients with liver cancer (31 hepatocellular carcinoma, 24 metastatic disease) were enrolled, and 124 IAT procedures were performed. A total of 36 patients underwent at least 1 intervention each with TRA and TFA. Of those, 29 patients (81%) preferred TRA and 7 (19%) preferred TFA (ratio, 4:1; P <.001). Median radiation exposure to the operator was significantly lower for TRA (5.5 mrem) vs TFA (13 mrem; P =.01). Incidences of complications, procedure time, contrast agent volume, and radiation exposure to patients were similar between groups. Conclusions: TRA was the preferred access for the majority of patients and was associated with less radiation exposure to the operator. No differences were detected in incidence of adverse events, procedure time, contrast agent volume, or patient radiation exposure.