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A New Approach in Heart Catheterizations

A cardiac catheterization is a procedure used to evaluate blood flow to the heart and the heart's pumping ability.  Traditionally, a catheterization is performed by inserting a catheter, (a very small, thin tube), into an artery.  The catheter is then fed through the body's circulatory system to reach the heart. 

Heart catheterizations have been performed for years by cardiologists through an artery in the patient's leg, or more accurately in the groin.

Now, cardiologists at McLeod can also perform this procedure by using a transradial approach, which is through the artery in the wrist. There are several advantages of this new approach that patients can expect, including a reduced risk of vascular and bleeding complications, shorter duration of bed rest after the procedure and increased patient comfort. 

When catheterizations are performed in the groin area there is more soft tissue to navigate to access the artery.  If a patient should begin to bleed, it is harder to control the bleeding because you are pressing against soft tissue. With the wrist it is easier to compress the area to control bleeding. Studies have also shown significantly fewer complications when performing catheterization from the radial approach. 

McLeod Health Cardiovascular Procedures CatheterizationAnyone who has ever experienced a heart catheterization often remembers the hours of lying completely still with a compression weight on the insertion site at the groin.  The wrist insertion site only requires one to two hours of applying a small plastic band about the size of a wrist watch.  It velcro's onto the wrist and then is inflated with a small amount of air to add pressure to the insertion site.  This means the patient is virtually eliminated from the need for extended bed rest and it allows for earlier discharge. 

At this time, transradial is used for diagnostic purposes and, in many cases, may also be used for the placement of stents, which are tiny mesh wire coils used to keep blocked arteries open.

Not every patient is a candidate for transradial catheterization.  In order to determine if there is adequate circulation, the cardiologist may perform an Allen’s test. Both arteries in the wrist are compressed simultaneously. Then pressure is released on the second artery (the ulnar) to make sure that it provides adequate blood supply to the hand. A small percentage of people will not have adequate supply and may not be candidates for transradial catheterization. In addition, there may be other considerations which would make the femoral approach preferable.



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