Having an coronary angiogram or heart stent placed via the wrist approach is common in Europe. India and Japan — much less so in the U.S. — even though the wrist (transradial) approach offers lower complications and higher patient comfort. Some studies have even shown that the radial approach, with its significantly lower bleeding complications, is superior in treating heart attacks (STEMI) since those patients need to be on high levels of anticoagulation meds.
So why are only 5% of U.S. procedures done via the wrist while figures in other countries run 50-80%? One reason has been training. In the U.S. cardiology fellows are trained in the femoral (leg/groin) approach, because that’s what’s practiced at their hospitals. So it’s been a self-perpetuating practice. Continue reading