목적: 간암 환자 치료에 있어 요골동맥 천자를 통한 동맥화학색전술의 가능성 및 유용성에 대해 평가해 보고자 하였다. 대상과 방법: 요골동맥을 통한 동맥화학색전술을 시행 받은 29명의 간암환자(평균연령:63세)를 대상으로 하였다. 안전 시술을 위하여 modified Allen’s test에서 음성인 경우에만 시행하였으며 모든 예에서 저자들이 고안한 Radial approach Hepatic Artery(RHA) 카테터를 사용하였다. RHA카테터의 간동맥 진입 여부, 요골동맥 천자 회수, 시술 시간, 지혈 시간 및 합병증을 알아보았다. 결과: 요골동맥을 통한 동맥화학색전술은 상완동맥의 해부학적 변이, 천자 실패, 간동맥의 해부학적 변이로 인해 실패한 3명의 환자를 제외한 26예(89.6%)에서 성공적이었다. 천자 회수는 평균 3.5회, 시술 시간은 평균 1시간 30분으로 시술 회수가 늘어날수록 점차 단축되었다. 시술후 지혈 시간은 평균 12분이었다. 주요 합병증을 동반한 경우는 없었으며 경미한 합병증으로는 요골동맥에서 발생한 경미한 내막박리 1예(3.8%)와 가역적인 혈관연축(vasospasm)이 2예(7.7%) 있었으며 그 밖에 시술 후 혈종(hematoma)형성 2예(7.7%), 일시적 손목 주위 신경학적 마비 1예(3.8%)등이었다. 결론: 요골동맥 천자를 통한 동맥화학색전술은 RHA카테터를 사용하여 가능하였으며, 고식적방법으로 인한 지혈을 위한 절대 침상 안정의 단점을 보완할 수 있는 유용하고 안전한 방법으로 고려될 수 있을 것이다.

Purpose: To evaluate the feasibility and usefulness of the transradial approach for intra-arterial chemoembolization therapy in patients with hepatocellular carcinomas. Materials and Methods: Twenty-nine patients with hepatocellular carcinoma who underwent intra-arterial chemoembolization via the radial artery approach were involved in this study. All underwent Allen’s test to check ulnar arterial patency. In all cases, we used the radial approach hepatic artery (RHA) catheter designed by ourselves, evaluating the selection ability of the hepatic artery using an RHA cathter, the number of punctures, the procedure time, and compression time at the puncture site as well as complications occurring during and after the procedure. Results: Except for three in which puncture failure, brachial artery variation or hepatic artery variation occurred, all procedures were successful. The mean number of punctures was 3.5, and the average duration of the whole procedure was one and half hours. This gradually decreased as the number of procedures increased. The average duration at a compression of puncture site was 12 minutes. There were no major complications. Minor complications included minimal intimal dissection of the radial artery (3.8%), reversible vasospasm of the radial artery (7.7%), hematoma at a puncture site (7.7%) and transient neurologic deficit (3.8%). Conclusion: The transradial approach using an RHA catheter for intra-arterial chemoembolization therapy in patients with hepatocellular carcinomas was technically feasible, with acceptable levels of safety. It may be a good alternative to absolute bed rest with a sand bag after the femoral approach.

Purpose: To evaluate the feasibility and usefulness of the transradial approach for intra-arterial chemoembolization therapy in patients with hepatocellular carcinomas. Materials and Methods: Twenty-nine patients with hepatocellular carcinoma who underwent intra-arterial chemoembolization via the radial artery approach were involved in this study. All underwent Allen’s test to check ulnar arterial patency. In all cases, we used the radial approach hepatic artery (RHA) catheter designed by ourselves, evaluating the selection ability of the hepatic artery using an RHA cathter, the number of punctures, the procedure time, and compression time at the puncture site as well as complications occurring during and after the procedure. Results: Except for three in which puncture failure, brachial artery variation or hepatic artery variation occurred, all procedures were successful. The mean number of punctures was 3.5, and the average duration of the whole procedure was one and half hours. This gradually decreased as the number of procedures increased. The average duration at a compression of puncture site was 12 minutes. There were no major complications. Minor complications included minimal intimal dissection of the radial artery (3.8%), reversible vasospasm of the radial artery (7.7%), hematoma at a puncture site (7.7%) and transient neurologic deficit (3.8%). Conclusion: The transradial approach using an RHA catheter for intra-arterial chemoembolization therapy in patients with hepatocellular carcinomas was technically feasible, with acceptable levels of safety. It may be a good alternative to absolute bed rest with a sand bag after the femoral approach.

Liver neoplasm, chemotherapeutic infusion, Arteries, peripheral, Angiography, complications, Angiography, technology