Objectives:To develop and internally validate a pre-treatment score for the safe selection of the best candidates for the transradial approach when performing liver cancer intra-arterial procedures.Methods:One hundred and twenty-two patients undergoing hepatic endovascular treatments via radial access between January and December 2022 were retrospectively selected to develop a prediction model. Pre-procedural imaging data were analyzed, and variables were selected to develop the RAD-access score. Intra-procedural data were analyzed to assess effective procedural complexity (ePC). The relationship between ePC and pre-procedural variables was statistically tested, and cutoff points were defined.Results:A final score (RAD-access) was created and prospectively validated on 139 patients enrolled between June and September 2023. Aortic arch diameter and angulation, left subclavian artery angulation, suprarenal abdominal aorta diameter, celiac trunk take-off angle, and radial artery diameter were the significant variables used to build the score. In the validation cohort, based on the pre-treatment RAD-access score, 69 patients underwent a transradial approach, with a significantly lower ePC rate obtained (78.2% easy, 20.3% intermediate, 1.5% complex). No major adverse events occurred.Conclusions:Pre-treatment RAD-access score provides a good prediction for the procedural complexity of the transradial approach in patients undergoing liver cancer intra-arterial treatments, identifying the best candidates for an easy and safe transradial procedure.
目的：开发并内部验证一项治疗前评分，以安全筛选最适合经桡动脉入路进行肝癌动脉内介入治疗的患者。 方法：回顾性选取2022年1月至12月期间经桡动脉入路接受肝脏血管内治疗的122例患者，用于构建预测模型。分析术前影像学数据，筛选变量构建RAD-access评分。通过分析术中数据评估实际手术复杂度（ePC），检验ePC与术前变量的统计学关系并确定截断值。 结果：构建最终评分（RAD-access）后，于2023年6月至9月期间前瞻性纳入139例患者进行验证。主动脉弓直径与角度、左锁骨下动脉角度、肾上腹主动脉直径、腹腔干起始角度及桡动脉直径是构建评分的关键变量。在验证队列中，根据治疗前RAD-access评分筛选的69例患者接受经桡动脉介入治疗，其ePC显著降低（78.2%为简易操作，20.3%为中等难度，1.5%为复杂操作），且未发生严重不良事件。 结论：治疗前RAD-access评分能有效预测肝癌动脉内治疗患者经桡动脉入路的手术复杂度，可精准筛选适合接受简易安全经桡动脉介入治疗的最佳候选者。
肿瘤(癌症)患者之家