Each year, more than a million people in the U.S. require a cardiac catheterization. It is a procedure in which a long, thin tube is threaded through a blood vessel to the heart. A contrast liquid that shows up under X-ray is injected into the heart artery, so the cardiologist can see the arteries and check for blockages.
Cardiac catheterization is a very common procedure. Historically, it has been done through the femoral artery in the groin. However, since the first article on catheterization was published in 1988, there has been a slow, but steady increase in the number of cardiologists who have been performing the procedure through the radial artery in the wrist.
“My patients have overwhelmingly preferred the radial artery approach to catheterization,” says Daniel Dunker, MD, FACC, a cardiologist with the Carondelet Heart Institute. “It is more comfortable, especially for patients with back discomfort as they can sit up right away, and there’s an added benefit of less bleeding complication.”
Dr. Dunker has been using the radial approach for the past several years and now does most catheterizations that way. “In some cases, we can perform even acute heart attack treatment through the wrist,” he adds, “thereby significantly reducing risk in this already high risk population.”
When the cardiologist goes into the blood system through the femoral artery in the groin, patients must lie still for four to six hours, and that can be uncomfortable for some patients. But when the radial artery is used, patients can sit up right away and move off the procedure table. They can sit in a chair rather than lie still through recovery.
“If there is bleeding, it can be recognized and controlled quickly,” says Dr. Dunker. Studies comparing the two approaches found both were equally successful at opening blockages. “Because patients are able to move around so much sooner and the risk of bleeding is lowered, there is also a significant cost savings.”
As more patients are learning about the procedure and requesting it, more cardiologists are adopting the practice. Most patients are good candidates for the procedure. The Carondelet Heart Institute at St. Mary’s is a leader in the area. About half of the cardiac catheterization procedures done at St. Mary’s are radial access cases compared with about 15 percent of patients at hospitals nationally.