A new technique for common cardiac procedures that check blood flow in the heart and clear blocked arteries may lead to fewer complications. The technique, called transradial angiography, may also lead to reduced recovery time and hospital costs.
Transradial angiography is an imaging technique that checks blood flow in the heart through an artery in the wrist. Traditional cardiac catheterization (coronary angiogram) and angioplasty procedures use an artery in the groin.
"It's a simple change that has a dramatic impact on the experience and recovery of the patient," Dr. Adhir Shroff, assistant professor of cardiology at the University of Illinois, said in a statement.
In the procedure, a catheter is threaded through the small radial artery in the wrist rather than the larger femoral artery in the groin (the most common method) or the "brachial" approach, which inserts the catheter at the bend of the elbow.
Even though complications from catheterization through the groin are low and occur in only 2 percent to 9 percent of patients, the transradial approach can reduce bleeding — the most common complication, particularly among women and the elderly—to under 1 percent. It also eliminates much of the discomfort associated with the procedure.
According to Shroff, standard angiogram or angioplasty (the procedure that widens narrow or obstructed blood vessels) requires the patient to lie still on his or her back for four to six hours, which can be very uncomfortable for some, especially patients with back problems. With a transradial procedure, patients can immediately sit up, eat, and walk without pain.
In Europe, up to 60 percent of procedures use the wrist method compared to only about 2 percent in the U.S.
"The issue is really just the learning-curve," said Shroff. "The change requires dozens of small changes — everything from redesigning the sterile drape so that the openings are at the wrist rather than the leg and finding smaller needles, wires, and catheters, to the way the table is set up."
Schroff says there is no downside to using the transradial approach where appropriate.
"And in these times, as everyone tries to think strategically about the delivery of healthcare, the savings in terms of costs and hospital resources offered by transradial catheterization make it especially attractive," he said. "It is my belief that once a patient has their procedure done from the wrist, they will demand that approach in the future, if they require it again."
According to surgery.com, more than three million cardiac catheterizations are expected to be performed in the U.S. in 2010.
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