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Interest in Transradial Angioplasty Growing Among U.S. Cardiologists
Patients Prefer the Wrist Technique for Stents or Angioplasty;
Training of Cardiologists is a Key Issue

June 10, 2008, New York -- In many countries around the world, angioplasty or stenting is done through an artery in the wrist 30-50% of the time. A recent study reported half the bleeding complications and lower mortality with this method. Additionally, patients are able to sit up and walk almost immediately after the procedure -- eliminating the hours of manual compression and lying flat on their backs.

Yet in the United States, the use of this technique, called transradial angioplasty, remains in the low single digits. One of the reasons has to do with the training of interventional cardiologists.

Kirk Garratt, MD
Kirk Garratt, MD, MSc.

According to Dr. Kirk Garratt, Director of Clinical Research at Lenox Hill Heart and Vascular Institute of New York:

"Despite the benefits of transradial access, most fellowship training programs continue to train clinical and interventional cardiologists using a transfemoral technique. That perpetuates the practice.

"Here at Lenox Hill, we make special efforts to train our fellows in competency with the radial approach. Half of the fellows we graduate end up using radial access as their preferred access route, if for no other reason than to capture that differentiator in a competitive marketplace."

For those cardiologists who have not trained at a center where radial access is practiced, an alternative is to attend a live demonstration course, such as the one being held this week at St. Vincent's Hospital in Manhattan by Drs. John Coppola and Tak Kwan. Joining the St. Vincent's cardiologists will be Dr. Shigeru Saito of Kamakura, Japan, one of the world's leading practitioners of transradial intervention (read our exclusive interview with Dr. Saito).

During two-days, cardiologists will receive hands-on training, covering the clinical, didactic and practical aspects of Transradial Access. The course, one of several held around the country, was already fully subscribed two weeks in advance, showing increased interest by cardiologists wishing to offer their patients the advantages of radial access.

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Drs. Coppola and Saito during transradial case at St. Vincent's

Dr. Coppola
John T. Coppola, MD


One of the main reasons why Dr. Coppola of St. Vincent's uses the transradial approach, whenever possible, is safety. As Dr. Coppola tells Angioplasty.Org:

"For the patients, the benefit is that it's a safer procedure. There's a lack of bleeding. And everything that's coming out now in the literature suggests that if you have bleeding complications, it impacts not only on your short-term, but your long-term survival.... [For the cardiologist,] having that benefit in terms of less bleeding makes you more willing to use potent antiplatelet agents, like IIb/IIIa inhibitors...because you're not worrying about retroperitoneal bleeds or groin hematomas."

To assist in educating the professional and patient population in the U.S. about the this technique, Angioplasty.Org has created the "Radial Access Center for Transradial Approach", a special section devoted to information and news about the transradial technique, for both patients and physicians. The Radial Center features interviews with leading practitioners of the radial technique, such as Drs. Jeffrey Popma, R. Lee Jobe, John Coppola, Shigeru Saito, Kirk Garratt and Howard Cohen.

For patients there is also a "Hospital Locator" that lists U.S. centers practicing radial angiography. As Dr. Howard Cohen, also of Lenox Hill Hospital, says of the wrist technique, "Patients really prefer it. 95% of people who've had it both ways would say 'I'm coming back to you, Dr. Cohen because I like this transradial a lot better than the other way!'


Reported by Burt Cohen, June 10, 2008