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.
But this is changing. Rapidly.This fall no less than eight major training courses in the transradial technique were scheduled: from North Carolina to San Francisco (you can see these on Angioplasty.Org’s list of upcoming transradial approach training courses) — more than were available during an entire year, maybe two, just a short while ago.
Next up on October 14 is a one-day course in San Francisco, the Transradial Intervention Program (TRIP) that since last November has been held at a number of centers by the Society for Cardiovascular Angiography and Interventions (SCAI). The following weekend of October 20-21 is the first advanced two-day course being run by Duke Clinical Research Institute, which also conducted a one-day course last weekend.
November brings a course at the Mid-America Heart Institute in Kansas City, MO and then an afternoon of over 20 presentations at the TCT 2011 meeting in San Francisco, the largest annual gathering of interventional cardiologists in the U.S.
Patients and physicians who want to learn more about this growing technique can read more about it at Angioplasty.Org’s Transradial Access Center.