Cardiac Caths Performed Through the Wrist

TRI Access 3. Cardio caths in wrist.

Each year, more than one million cardiac caths (catheterizations) are performed in the United States and more than 90 percent go through the groin to gain access to the arteries that lead to the heart (transfemoral access). However, cardiologists at the Cardiovascular Institute are increasing the number of procedures performed through the wrist (or transradial access). Why? This access approach is improving patient comfort and recovery times.
“Once the artery is engaged,” says Samir Patel, M.D., interventional cardiologist, “whether through the wrist or the groin, the diagnostic and interventional procedures are virtually the same.” One big difference, however, is what happens at the end of each procedure. With transfemoral access, the patient must have pressure applied to the puncture site and lie flat for several hours post procedure under the observation of a nurse or technician. This is necessary to ensure the transfemoral access site reaches hemostasis (no further bleeding). “With transradial access, a wrist band applies pressure to the access site following the procedure, which enables patients to be mobile much faster and have less soreness during recovery,” says Dr. Patel. “Patients are able to get up almost immediately after the procedure, they can use the bathroom, sit up and read a newspaper, eat or have a cup of coffee.”
“While the transfemoral approach is more common,” says Amir Haghighat, M.D., interventional cardiologist, “the entry point is sometimes difficult to access, especially in heavier patients and sometimes in women. In these cases, using transradial access to perform the procedure can reduce the risk of excess bleeding. However, for more complex cases, gaining access through the femoral artery, a larger vessel, remains the standard.”
The increased use of transradial access is not only helping patients to regain mobility faster following the procedure, but in select cases, patients are able go home the same day rather than stay overnight in the hospital. “Our group is excited to work with Bay Medical to gradually increase usage of this access method for cardiac caths,” says Dr. Haghighat. “Working together with the hospital, we are continually improving the quality of heart care available to patients in our community.”