Feasibility and safety of the left radial artery approach for pre-cryoablation lipiodol marking in small renal cell carcinomas

BACKGROUND: This study evaluated the feasibility of lipiodol marking using the left radial artery (LRA) approach prior to cryoablation for small renal cell carcinoma (RCC). METHODS: This retrospective study included 59 patients who underwent transarterial lipiodol marking before cryoablation between August 2022 and December 2023. The LRA approach was attempted in 46 patients; 13 patients ineligible for LRA underwent femoral artery (FA) puncture as a descriptive comparator. The primary endpoint was technical success without crossover among attempted LRA cases; secondary endpoints included overall feasibility among candidates, failure reasons, adverse events (AEs), and procedural metrics. RESULTS: = 1), completed via FA crossover. Grade I AEs included forearm haematoma (26.1%), LRA occlusion (2.2%), and brachial artery dissection (2.2%). Procedure and fluoroscopy times were longer in the successful LRA cases than in the FA cohort (median 86 vs. 63 min and 1256 vs. 851 s, respectively). CONCLUSIONS: LRA-based lipiodol marking achieved technical success in most attempted cases. AEs were manageable but not negligible. Prospective studies are warranted to clarify patient-centred benefits and optimal selection criteria.