Angioplasty.Org
Most Popular Angioplasty Web Site
    Radial Center on Angioplasty.Org Radial Center on Angioplasty.Org with support from Medtronic Cardiovascular
Transradial Access from the Wrist is Safer, Easier For Many Patients Undergoing Angioplasty or Stenting of Blocked Heart Arteries

external sites:
ISET 2009

ISET 2009    

January 19, 2009 -- A new approach to unblocking heart arteries minimally invasively using angioplasty or stents will mean less bleeding, less down time, lower costs and less risk overall, particularly for obese patients, according to data being presented at the 21st annual International Symposium on Endovascular Therapy (ISET).

Every year, about one million Americans opt for angioplasty over bypass surgery to open their blocked arteries. New data suggests that beginning the angioplasty procedure by entering through the wrist – rather than through the groin – will make it safer and easier on patients.

To access the arteries, an interventional physician makes a small incision in the groin at the top of the leg and advances a thin tube (catheter) through the femoral artery to the site of the blockage. A tiny balloon is then inflated to open up the artery, and often a small cage-like tube called a stent is left behind to keep it open. But there is a risk of bleeding and nerve damage at the femoral artery access site. To reduce the risk, patients must lie down for two to six hours after treatment. Also, accessing the femoral artery in the groin is particularly challenging and risky in obese people.

Accessing the blocked blood vessels through the wrist (radial) artery, rather than the femoral artery significantly reduces the risk of bleeding and nerve damage, suggests data on more than 5,000 procedures performed at Baptist Cardiac & Vascular Institute, Miami. The radial approach also is easier on patients because they can sit up after the procedure and walk away almost immediately.

Currently, in the United States, only about two percent of all minimally invasive heart treatments are performed through the wrist. The percentageof transradial procedures is higher in other countries, as much as 50% in some.

“I believe 75 percent of patients would be candidates for the radial approach if it were an option,” said Ramon Quesada, M.D., medical director of interventional cardiology at Baptist Cardiac & Vascular Institute, and ISET course director. “The radial approach is a bit more technically challenging for physicians, but once they master it, I think most would prefer it. One of the main barriers is a lack of training opportunities.”

When the femoral access approach is used, there is a 2.8 percent risk of bleeding or nerve damage, according to studies. Most patients spend at least one night in the hospital after the procedure. Although rare, the bleeding can lead to kidney failure, blood infection and death. At Baptist Cardiac & Vascular Institute, the complication rates for the radial approach are extremely low; only 0.3 percent had bleeding complications. None suffered nerve damage. An overnight stay may be advisable, depending on the complexity of the intervention performed, not because of the access approach.

The radial approach isn’t appropriate for all patients, including those who have very small or twisted arteries or are extremely thin, said Dr. Quesada.

“Using the radial approach results in lower cost, less time before the patient can get up and walk around and fewer complications,” said Dr. Quesada. “Patients who are ideal candidates for the radial approach are those who are obese or have severe peripheral arterial disease (PAD).”

Considered to be the premier meeting on endovascular therapy, the International Symposium on Endovascular Therapy (ISET) is attended by more than 1,200 physicians, scientists, allied professionals and industry professionals from around the world. The meeting pioneered the use of live cases to promote the multidisciplinary treatment of cardiac and vascular disease by endovascular means. ISET is presented by the Baptist Cardiac & Vascular Institute, Miami. ISET 2009 is taking place Jan. 18-22 near Miami Beach, Fla. For more information, visit www.ISET.org.

About The Radial Access Center on Angioplasty.Org
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, Tak Kwan and Howard Cohen.

For patients there is also a "Hospital Locator" that lists U.S. centers practicing radial angiography. As Dr. Howard Cohen of Lenox Hill Hospital in New York 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!'

Source: International Symposium on Endovascular Therapy with additional reporting by Burt Cohen