Comparative Study of Outcomes of Transradial Versus Transfemoral Approach for Hepatic Arterial Embolization Using Transarterial Chemoembolization (TACE) Technique in Patients with Hepatocellular Carcinoma at a Tertiary Care Hospital

Hepatocellular carcinoma (HCC) is among the leading causes of cancer-related deaths worldwide. Transarterial chemoembolization (TACE) remains the standard locoregional therapy for intermediate-stage disease. Traditionally performed via the transfemoral approach (TFA), the transradial approach (TRA) has emerged as a promising alternative due to fewer access site complications, shorter hemostasis time, and greater patient comfort. This comparative observational study, conducted at a tertiary care hospital, evaluated 38 HCC patients undergoing TACE—19 via TRA and 19 via TFA. Technical success, fluoroscopy time, contrast volume, post-procedural pain, hemostasis time, hospital stay, and cost were analyzed. Technical success was comparable between TRA (94.7%) and TFA (89.5%). However, TRA showed significantly reduced hemostasis time (15.8 ± 3.4 min vs. 22.1 ± 4.2 min, p = 0.001), lower pain scores (2.5 ± 1.3 vs. 3.9 ± 1.7, p = 0.019), shorter hospital stay (12.5 ± 2.1 h vs. 16.8 ± 3.5 h, p = 0.008), and lesser contrast use (65.2 ± 8.1 mL vs. 72.5 ± 9.3 mL, p = 0.021). Access site complications were lower with TRA (10.5% vs. 15.8%, p = 0.559) though not statistically significant. Overall, TRA demonstrated improved procedural efficiency, patient comfort, and cost-effectiveness without compromising technical success. These findings reinforce the safety and practicality of the transradial route for hepatic arterial embolization in HCC patients undergoing TACE. Approach depends largely on operator expertise and familiarity with radial artery anatomy, as emphasized by Al-Hakim et al., (2016) in Cardiovascular and Interventional Radiology. The study also corroborated that socio-demographic variables, such as age, gender, BMI, smoking status, alcohol consumption, and comorbidities, did not significantly impact procedural outcomes, indicating that transradial access is suitable for a diverse population.