ArticleBMC cancer2026
Efficiency and safety of a guidewire-less approach to superselective transarterial microcatheter procedures in hepatic cancer interventions.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNo study of patients with hepatocellular carcinoma (HCC) has compared the procedure time of transcatheter arterial chemoembolization (TACE) using guidewire-less and guidewire techniques. The present study aimed to further compare the procedure time and radiation exposure of the “Wireless Angiographic VEssel Selection” (WAVES) technique, hybrid procedure and conventional guidewire TACE.
methodsProcedure time and radiation dose were compared between patients with HCC treated with the WAVES (n = 125) or conventional TACE (n = 59). Among WAVES group, 36 patients were switched to conventional procedure if the desired location could not be reached after 3 min of initiated WAVES procedure (hybrid group). In the per-treatment analysis, procedure and radiation dose were also compared between the 3 group.
resultsWAVES procedure (β = -13.694, 95% confidence interval [CI]: -18.215, -9.173, p < 0.001) was an independent predictor of shorter procedure time compared to a conventional procedure. A longer procedure time was an independent predictor of higher radiation dose (β = 14.216, 95% CI: 12.654, 15.777, p < 0.001). After stratifying for vessel type (moderate difficulty [MD] and high difficulty [HD]), an association between WAVES and shorter procedure time was also found in both MD (WAVES vs. conventional: β = -21.085, 95% CI: -28.799, -13.371, p < 0.001) and HD (WAVES vs. conventional: β = -10.784, 95% CI: -16.644, -4.924, p < 0.001) subgroups. An association between longer procedure time and higher radiation dose was also found in both MD (β = 14.938, 95% CI: 12.694, 17.183, p < 0.001) and HD (β = 13.617, 95% CI: 11.293, 15.942, p < 0.001) subgroups. In the per-treatment analysis, the similar associations between WAVES procedure and procedure time and radiation dose as compared to conventional procedure. In addition, hybrid procedure (β = -12.202, 95% CI: -17.697, -6.708, p < 0.001) was as an independent predictor of shorter procedure time compared to a conventional procedure. A longer procedure time was an independent predictor of higher radiation dose (β = 14.389, 95% CI: 12.962, 15.816, p < 0.001). After stratifying for vessel type, an association between hybrid procedure and shorter procedure time was only found in the MD subgroup (hybrid vs. conventional: β = -19.771, 95% CI: -34.280, -5.263, p = 0.009), but this association was not observed in the HD subgroup (hybrid vs. conventional: β = -6.595, 95% CI: -15.894, 2.705, p = 0.160). An association between longer procedure time and higher radiation dose was also found in both MD (β = 15.046, 95% CI: 13.097, 16.995, p < 0.001) and HD (β = 13.869, 95% CI: 11.719, 16.018, p < 0.001) subgroups.
conclusionThe use of WAVES or hybrid procedure is associated with shorter procedure duration in patients with HCC undergoing TACE, which reduces radiation dose. It may be deployed as a first-line approach for MD rather than HD vessels.
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