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Purpose: This study evaluated the feasibility of sheathless access using the combination of a 4-F catheter and a triaxial system for transcatheter arterial chemoembolization (TACE). Materials and Methods: A total of 35 of 53 patients were selected to undergo TACE of hepatocellular carcinoma (HCC) using a triaxial system that included a 4-F shepherd hook catheter, a 2.7-2.9-F high-flow microcatheter, and a 1.7-1.9-F microcatheter without using a sheath introducer. Feasibility was defined as successful completion of the procedure without using another microcatheter or switching to another system. The duration of manual compression after catheter removal was set to 10 minutes. Two hours and 1 hour of bed rest after the procedure were prescribed for 24 and 11 patients, respectively. Results: TACE using a triaxial system without a sheath introducer was feasible in 34/35 cases (97%). A small amount of bleeding around the catheter at the puncture site was observed during the procedure in 3 cases. No other hemorrhagic complications were observed 5 days after the procedure. Conclusion: Sheathless arterial access using the combination of a 4-F catheter and a triaxial system for TACE of HCC was shown to be both feasible and safe. Additionally, using the triaxial system resulted in hemostasis within 1-2 hours of bed rest after catheter removal.

interventional radiology

Feasibility of a Sheathless Arterial Access Using a 4-F Catheter and a Triaxial System for Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma