Transfemoral Approach Using a 3.5―French Catheter System for Use in Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma: Technical Assessment

Background/Aims: To evaluate the technical feasibility of the transfemoral approach using a 3.5-Fr catheter system for transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methodology: This study included 81 patients with unresectable HCC who underwent transfemoral TACE using a 3.5-Fr catheter system without a sheath between August 2008 and June 2010. A 2.0-Fr microcatheter was used within a 3.5-Fr catheter in all cases. After completion of TACE, manual compression was applied to the puncture site for 5min, and patients were kept supine for 1h. The success rate and periprocedural complications of TACE were evaluated. Results: Transfemoral TACE with a 3.5-Fr catheter system was carried out in 103 transfemoral TACE sessions. TACE was performed for 103 subsegmental arteries, 19 segmental arteries, 13 lobar arteries, 8 right inferior phrenic arteries, 1 left inferior phrenic artery, and 1 inferior pancreatico-duodenal artery. Image quality in all hepatic angiograms using 3.5-Fr catheters was satisfactory. Technical success was achieved in 97 (94%) out of 103 procedures. In only 1 patient, it took 10min to achieve hemostasis. There were no periprocedural complications. Conclusions: Transfemoral TACE using a 3.5-Fr catheter system is technically feasible and enables early ambulation safely in patients with HCC.