03-01-2024 | Interventional Radiology | Commentary
Is It Time to Push for Outpatient Care and Broader TRA Approach Application?
Commentary on: French Interventional Radiology Centers’ Uptake of Transradial Approach and Outpatient HCC Intra-Arterial Treatments
Authors:
Roberto Iezzi, Alessandro Posa
Published in:
CardioVascular and Interventional Radiology
|
Issue 4/2024
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Excerpt
We read with interest the study by Grégory and colleagues, investigating the adoption of transradial access (TRA) and outpatient care for intra-arterial treatments of hepatocellular carcinoma (HCC) within French interventional radiology (IR) centers, using a 34-questions survey [
1]. The questionnaire helped to portray the current state of IR practice in French hospitals regarding transarterial chemoembolization (TACE) and transarterial radioembolization (TARE). This survey is interesting as it sheds light on the trending topic of outpatient transradial techniques for HCC treatment. Overall, among the 44 centers that answered the survey, the adoption of TRA is seen as a positive development in IR practice, with reduced complication rates and enhanced patient comfort. However, in the context of liver intra-arterial interventions, even though TRA has been adopted in 39% of responding centers, it is routinely performed only in 20% and 10% of TACE and TARE procedures, respectively. The most common obstacles to TRA adoption are said to be represented by lack of expertise or training on TRA, no perceived benefits, and risk of complications. The study unveils a growing interest in outpatient care, with therapeutic outcomes comparable to standard inpatient care, and higher patient satisfaction rates. However, the study reveals that only six centers reported performing outpatient TACE or TARE, due to concerns regarding complications and readmissions, particularly in complex cases, as well as organizational challenges (i.e., limited spaces, patient fragility), which underscore the need for a meticulous patient selection and an accurate evaluation of risks and benefits. Furthermore, future trials would have to evaluate whether outpatient setting could also be competitive from an economic point of view. …