Angioplasty via wrist may be safer

The best way of accessing and treating ailing hearts with angioplasty may be through the wrist, a US study finds.

The catheterisation technique reduces risk, bleeding, cost and patient recovery time when treating blocked arteries, researchers said.

Each year, about one million Americans undergo angioplasty to open blocked arteries. The most common approach involves making an incision in the groin (at the top of the leg) and inserting a catheter (thin tube) that’s advanced through the femoral artery to the site of the blockage. A tiny balloon is inflated to open the blocked artery and, in many cases, a stent is left behind to keep the artery open.

Due to the risk of bleeding and nerve damage at the femoral artery access point, patients must lie down for two to six hours after treatment. In obese patients, accessing the femoral artery in the groin can be challenging and risky.

Researchers at the Baptist Cardiac & Vascular Institute in Miami reviewed data on more than 5,000 procedures and concluded that accessing blocked arteries through the wrist (radial) artery significantly reduces the risk of bleeding (0.3 percent) and nerve damage (0 percent) compared with femoral artery access (2.8 percent risk of bleeding or nerve damage).

The study was presented at the annual International Symposium on Endovascular Therapy (ISET) in Hollywood, Fla.

“Using the radial approach results in lower cost, less time before the patient can get up and walk around and fewer complications,” Dr. Ramon Quesada, medical director of interventional cardiology at the institute, said in a news release.

Currently, wrist access is used in only about 2 percent of angioplasty procedures. The wrist approach isn’t appropriate for all patients, including those who are extremely thin or have small or twisted arteries.

“I believe 75 percent of patients would be candidates for the radial approach if it were an option. 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,” Quesada said. The News

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