Most of the 1 million heart catheterizations performed each year in the United States are performed by accessing arteries to the heart through the groin. But interventional cardiologists at the Stony Brook University Heart Center and elsewhere are performing more heart catheterizations by going through the wrist instead of the groin, a process called "transradial access." The procedure has several advantages for patients including reduced complications, increased patient comfort, and quicker recovery time.
“We are expanding our use of transradial access for both diagnostic and interventional procedures to ensure better patient outcomes and comfort,” says Luis Gruberg, M.D., Professor of Medicine, Division of Cardiovascular Medicine, Stony Brook University School of Medicine. “As a general rule, patients and their referring physicians have embraced this procedure, as it enables the patient to be mobile and sitting up much faster after the procedure and with less post-procedure pain.
“Small but significant changes can have a great impact on medical outcomes, costs, and patient satisfaction, and a change in access points for catheterization is one of these,” adds Dr. Gruberg, referring to growing use of transradial access at the Heart Center.
Once the artery is accessed, the diagnostic and interventional procedures are virtually the same for both groin (transfemoral) and wrist (transradial) catheterizations. With groin access, however, the patient must lie flat for four to six hours after the procedure. This is necessary to ensure that there is no bleeding from the puncture site. With wrist access, patients are able to get up almost immediately after the procedure, allowing them to walk, sit upright, use the bathroom, and eat and drink.
The first transradial diagnostic catheterization was performed by Dr. Lucien Campeau, a French/Canadian physician, in the late 1980s. By 1993, a research team in Amsterdam, led by Dr. Ferdinand Kiemeneij, began using the technique for interventional procedures. In recent years, the method for catheterization has grown and is seen by some interventional cardiologists as an optimal choice for a significant segment of the patient population.
