Advantages of distal radial artery approach through the left snuff fossa for hepatic artery chemoembolization

[Objective] To explore the therapeutic methods and advantages of transcatheter arterial chemoembolization through the radial artery approach at the distal end of the left snuffbox in elderly patients. [Methods] A total of 956 elderly patients who underwent transcatheter arterial chemoembolization in the First Hospital of Jilin University from July 2020 to July 2023 were retrospectively analyzed. They were divided into a femoral artery group (n=779), a proximal radial artery group (n=14) and a left snuffbox distal radial artery group (n=163) according to different access diameters. Postoperative vascular complications, comfort and related surgical indicators were compared among the three groups. [Results] There were significant differences in the incidence of postoperative thrombosis among the three groups (P<0.05). The incidence of postoperative thrombosis in the proximal radial artery group was higher than that in the femoral artery group and the left snuffbox distal radial artery group(P<0.05). The differences in the incidence rate of postoperative limb pain and numbness among the three groups had statistical significance (P<0.05); the incidence rate of postoperative limb pain and numbness of surgical limbs in femoral artery group was higher than that in the left snuffbox distal radial artery group (P<0.05). There were significant differences among the three groups in postoperative limb compression time, postoperative bed rest time, postoperative deflation/decompression times, cumulative puncture times of approach artery, and cost of compression materials (P<0.05).Among them, the left snuffbox distal radial artery group had the shortest compression time of operated limb, postoperative bed rest time, postoperative deflation/decompression times, cumulative puncture times of approach artery, and cost of compression materials were relatively less. [Conclusion] For elderly patients, transcatheter arterial chemotherapy through the distal radial artery of the left snuffbox can simplify the work and reduce the treatment workload, while the patients have fewer vascular complications, high comfort and less cost, which is conducive to clinical promotion.