Y90 Radioembolization of Liver Tumors via Radial approach – Correlation Between Common Femoral artery and Radial Artery Size

Abstract PurposeTypically, before Y90 radioembolization procedure undergoes, a CT is completed and the Barbeau test followed by radial artery ultrasound is used to determine if the artery is sufficiently large for vascular access [1-4]. 2.5 mm is the average radial artery diameter, and a vessel measurement of 2.0 mm is the recommended minimum diameter for safe vessel access, but a diameter of 1.5–2.0 mm can be accessed [4-9]. Our study explores using common femoral artery measurements from the pre-procedure CT abdomen/pelvis to assess in a binary manner if the vessel is sufficiently large to use for radial artery access. Materials and MethodsAll computed tomography scans of yttrium-90(Y90) radioembolization of the liver tumor procedures from January 1, 2015 - December 31, 2019 were retrospectively reviewed. Medical records were used from 47 procedures to gather patients' age, gender, Avastin use, femoral artery size (mm), administer Y90 (%), history of diabetes, and smoking status were recorded. ResultsThe minimum femoral artery size in patients who underwent transradial artery Y90 liver tumor radioembolization was 6 mm, with a mean femoral artery size of 10 mm. A comparative analysis of Y90 liver tumor uptake revealed no significant difference in radioembolization tumor uptake based on the initial site of procedure, transfemoral or transradial artery, (p > 0.81229). ConclusionThe study suggests that femoral arteries can predict radial artery diameter and that a femoral artery diameter of 10 mm should yield high confidence that the patient will be a candidate for transradial approach.