The American College of Cardiology estimates that roughly 1 million angioplasties are performed to clear heart blockages each year. In the procedure, a tube is inserted into a blood vessel in the thigh to reach the heart and insert a mesh tube that keeps the vessel open. This procedure saves lives but comes with potential complications and discomfort for the patient who experiences bleeding, and can’t sit up or move around much.
In a transradial angioplasty, the radial artery in the wrist is used to insert the catheter instead of the femoral artery in the groin. This procedure has the same results, costs less, takes less time and has fewer side effects for the patient. Surprisingly, it is used in only 5 percent of the cases in the United States.
“Patients prefer it by far,” says Dr. Howard Cohen, director of cardiac intervention at Lenox Hill Hospital in Manhattan. “They can walk, sit-up immediately and eat following the procedure. They can also go home in a few hours versus an overnight hospital stay when the procedure is done through the groin.”
A 2008 report published in the American College of Cardiology backs up Cohen’s assertions. Researchers at Duke University looked at angioplasty practices at more than 600 hospitals in the United States and found that bleeding risks are reduced by nearly 60 percent and there are fewer overall complications for patients who underwent the procedure through their wrists. They also found the wrist technique is better tolerated particularly by the elderly and/or obese.
In addition, traditional angioplasty through the femoral artery in the leg often requires heavy pressure afterward until bleeding stops at the puncture site. This is not the case when the procedure is performed through the wrist.
Although the procedure has been in the U.S. since the 1990s, it has a slow adoption rates. “It’s technically more difficult and, until recently, it wasn’t taught in a lot of the training programs,” says Cohen. “There is also a steep learning curve to the procedure.”
Cohen and his colleagues have been accessing coronary arteries through patients’ wrists for more than a decade. He estimates that 95 percent of the 40-50 angioplasties he and his colleagues perform each day are radial angioplasties.
CONNECT THE DOTS
Watch this video for more information about radial angioplasty. Also check out the Washington Post’s article, “To Inspect the Heart, Some Doctors Now Start at the Wrist.”
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