"Walking immediately after angioplasty" and "it was a piece of cake" are not how most patients who have undergone coronary catheterization and angioplasty typically describe the experience. Yet, an innovative approach to these procedures being performed at Lenox Hill Hospital is changing the process and recovery.
Traditionally cardiac catheterization is performed by making a small incision in the groin to access the femoral artery. The radial artery in the wrist, however, is smaller than the femoral artery and much easier to compress, reducing puncture-site bleeding complications and discomfort considerably. Compared with the traditional approach of femoral access, radial access allows many patients to get out of bed and walk immediately following the procedure.
The radial artery access has been used for approximately the past 10 years in the United States. Radial access is used in less than 1 per cent of the angiograms and angioplasties done in this country each year. This is because most heart specialists were trained on the femoral (groin) route and have used this approach throughout their career.
Coronary stenting using the radial artery involves a significant learning curve for physicians. At Lenox Hill Hospital, Howard A. Cohen, MD, Director of Cardiac Intervention and Co-Director of the Cardiac Catheterization Laboratories has done thousands of cases using this new approach and performs over 90% of his cases this way.
"Radial (wrist) access for coronary angioplasty is associated with less discomfort, and a recovery time as short as two hours," said Dr. Cohen. "I do most of my cases this way because complications are minimized and patient comfort and satisfaction is markedly increased. My patients are typically up and walking around immediately after the procedure."
According to a recent study published in the Journal of American College of Cardiology, inserting a heart catheter into the wrist, instead of the groin, is a safer technique for patients who are at high risk of developing bleeding complications. Patients are particularly at risk of bleeding complications if their blood clots because of a recent heart attack or unstable angina.
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