Cone-beam CT acquisition during transradial TACE made easy; use of the swivel arm board
Teo, Chia Chia
U, Pe Thet
Quek, Lawrence Han Hwee
Date of Issue2018
Lee Kong Chian School of Medicine
OBJECTIVE:Transradial access for peripheral intervention often requires certain modification from its coronary counterparts. One of the challenges during transradial transarterial chemoembolization (TACE) is the need for the access arm to be repositioned during cone-beam CT (CBCT) acquisition to allow for C-arm rotation. We recently introduced a swivel arm board to allow seamless repositioning of the access arm during and after CBCT acquisition. The purpose of this study is to detail the technique and feasibility of this useful adjunct to transradial TACE. METHODS:We performed a retrospective study of consecutive cases of transradial TACE between November 2015 and March 2016, which represented the period where we introduced the swivel arm board to our transradial procedure. A total of 20 transradial TACE using the swivel arm board was performed in 17 patients. There were 13 males and 4 females. The mean age was 69.5 years old (range 48–82 years). Indications for TACE included hepatocellular carcinoma (n = 14) and metastatic liver disease (n = 3). RESULTS:Transradial TACE was successful in all cases. A total of 40 successful arm repositioning using the swivel arm board for CBCT acquisitions were performed (100% success rate). There was no catheter or sheath dislodgement associated with the arm movements. No change in the microcatheter tip position was detected as a result of the arm repositioning. Hemostasis was successfully achieved in all the patients. There was no access related complication. CONCLUSION:The swivel arm board is a useful adjunct to enable CBCT acquisition during transradial TACE. ADVANCES IN KNOWLEDGE:Transradial TACE is a novel technique, and adaptation to allow for CBCT acquisition is currently challenging. This manuscript illustrates how to overcome the positioning difficulties with the use of the swivel arm board.
Transarterial Chemoembolization (TACE)
Cone-beam CT (CBCT)
Cone-beam CT (CBCT)
The British Journal of Radiology
© 2018 The Authors (Published by the British Institute of Radiology). This paper was published in The British Journal of Radiology and is made available as an electronic reprint (preprint) with permission of The Authors (Published by the British Institute of Radiology). The published version is available at: [http://dx.doi.org/10.1259/bjr.20170248]. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper is prohibited and is subject to penalties under law.