Right or Left: Which Is the Right Radial Access for Liver Transarterial Chemoembolization?

Objectives: This study aims to report on radial access for transarterial chemoembolization (TACE), comparing right and left accesses in terms of technical effectiveness, safety, operator radiation exposure, and procedural comfort. Methods: In a single-center prospective design, patients were randomized into two groups according to right (R) or left (L) radial access. Primary endpoints were used to assess the efficacy and safety of radial access to perform liver TACE interventions; secondary endpoints were used to compare procedural comfort and operator radiation exposure. Technical efficacy was intended as procedural accomplishment via sole radial access. Safety was assessed in terms of complication occurrence. Operator radiation exposure was monitored according to dosimeters and beam-on time. Patient and operator procedural comfort was investigated using a visual analog scale. Results: A total of 61 patients (17 women and 44 men; mean age 68.4 years) were enrolled. Group R included 32 patients, and group L had 29; all were affected by hepatocellular carcinoma and treated with palliative or bridge-to-transplant intent. Sixteen (26.2%) had abnormal coagulation function. Technical success did not statistically differ between the two groups (96.8% group R vs. 100% group L). No major complications were recorded. While no differences were detected in terms of radiation exposure values and patient comfort, operators were significantly in favor of the right radial artery. Conclusions: In this sample, both right and left radial access were technically effective and safe, without significant differences in operator radiation exposure and patient comfort; considering significantly higher operator comfort with the right approach, right radial artery could be considered the right radial access for liver TACE interventions.