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

Figures & data

Figure 1 The process to measure time to achieve hemostasis for all of the 134 TRA-TACE procedures.

Table 1 Clinical Characteristics of the 119 Patients with HCC Who Underwent Transradial Access Chemoembolization (TRA-TACE)

Characteristic	n = 119
Age, years	58.0 ± 9.6
Sex
Male	103 (86.6)
Female	16 (13.4)
Etiology
HBV	88 (73.9)
HCV	7 (5.9)
HBV + HCV	2 (1.7)
Others	22 (18.5)
ECOG Performance Status
0	111 (93.3)
1	8 (6.7)
Child-Pugh Class
A	106 (89.1)
B	13 (10.9)
BCLC Stage
A	33 (27.7)
B	62 (52.1)
C	24 (20.2)
Hypertension	30 (25.2)
Diabetes	23 (19.3)
PLT (×10^9 /L)	135.3 ± 64.5
INR	1.09 ± 0.12

Note: Data are presented as frequency (percentage) or mean ± standard deviation.

Abbreviations: HCC, hepatocellular carcinoma; HBV, hepatitis B virus; HCV, hepatitis C virus; ECOG, Eastern Cooperative Oncology Group; BCLC, Barcelona Clinic Liver Cancer; PLT, platelet count; INR, international normalized ratio.

Table 2 Outcomes of the 134 TRA Procedures in the 119 Patients

Items	n = 134
TRA-related outcomes
Technical success	134 (100)
Number of puncture attempts	1.2 ± 0.6
Puncture time, seconds	27.9 ± 25.6
Time of TRA-TACE, minutes	66.9 ± 25.1
Diameter of radial artery, mm
Baseline	2.7 ± 0.3
24 hours after TRA-TACE	2.8 ± 0.3
30 days after TRA-TACE	2.7 ± 0.3
TRA-related AEs	10 (7.5)
Major AEs (Grade 3 or 4)	0 (0)
Minor AEs (Grade 1 or 2)	10 (7.5)
● Pain	6 (4.5)
● Ecchymosis	4 (3.0)
● Hematoma	2 (1.5)
● Early RAO	1 (0.7)

Note: Data are presented as frequency (percentage) or mean ± standard deviation.

Abbreviations: TRA, transradial access; TACE, transarterial chemoembolization; AEs, adverse events; RAO, radial artery occlusion.

Table 3 Univariate and Multivariate Logistic Regression Analyses for Factors Predicting the Time to Remove the Compression Device (> 30 min or not)

Variables	Univariate Analysis		Multivariate Analysis
	p value	OR (95% CI)	p value	OR (95% CI)
Age > 65	0.215	1.942 (0.680, 5.547)
Female sex	0.161	2.462 (0.698, 8.680)
HBV infection	0.210	0.498 (0.168, 1.480)
BCLC Stage C	0.582	1.407 (0.417, 4.746)
Hypertension	0.021	3.444 (1.202, 9.871)	0.054	3.033 (0.982, 9.363)
Diabetes	0.270	1.905 (0.606, 5.986)
PLT < 100×10^9 /L	0.006	4.475 (1.532, 13.071)	0.016	3.942 (1.296, 11.989)
INR > 1.09	0.653	0.784 (0.271, 2.265)
TRA history	0.373	1.875 (0.470, 7.472)
RA diameter > 2.7 mm	0.275	0.555 (0.192, 1.599)
Number of puncture attempts > 1	0.031	3.443 (1.117, 10.615)	0.076	3.049 (0.890, 10.453)

Note: Statistically significant values are identified in boldface.

Abbreviations: OR, odds ratio; CI, confidence interval; HBV, hepatitis B virus; BCLC, Barcelona Clinic Liver Cancer; PLT, platelet count; INR, international normalized ratio; TRA, transradial access; RA, radial artery.

Figure 2 The cumulative hemostasis rate after transradial access chemoembolization (TRA-TACE) in patients with hepatocellular carcinoma. (A) The time to achieve hemostasis in all of the 134 TRA-TACE procedures. (B) The time to achieve hemostasis in patients with a platelet count < 100×10⁹ /L. (C) The time to achieve hemostasis in patients with a platelet count ≥ 100×10⁹ /L.

Figure 3 Modified patent hemostasis strategy based on platelet counts for transradial access chemoembolization (TRA-TACE) in patients with hepatocellular carcinoma.

Abbreviation: PLT, platelet count.