The best path to clear a clogged heart may now be through the wrist. In a new technique, cardiologists are now using the wrist instead of the groin for angiograms.
Although, blocked arteries are propped open through a needle puncture made in the femoral artery in conventional angioplasty, British cardiac surgeons are now carrying out the life saving procedure by making an incision through the radial artery in the wrist.
Consultant cardiologist Dr Rod Stables, of Liverpool Heart and Chest Hospital, who performs 95 percent of the angioplasties through the wrist stated, “This is the future of angioplasty. It is safer and more comfortable with the chances of complications much reduced. The patient, in most routine cases, can also go home much sooner,”
A little about angioplasty
Given that Coronary Artery Disease (CAD) is acquiring epidemic proportions, about a million artery-clearing angioplasties are performed worldwide and the usual route is to thread a tube to the heart through the femoral vessel in the groin.
Angioplasty is a well-established procedure to reduce or eliminate blockages in coronary arteries.
It restores blood flow in a clogged artery. A tiny balloon is inflated at the site of the blockage, pushing back the clog.
Doctors often insert a mesh tube called a stent to keep the artery propped open. It can be done during a heart attack, to alleviate worsening symptoms that signal a heart attack is imminent, or for nonemergency relief of recurring chest pain.
Radial angioplasty involves making a small incision in the wrist under a local anaesthetic.
There is significantly lower the risk of bleeding without the discomfort of patients lying flat for hours while the incision site seals up.
Going through the wrist is safer because the puncture site can be bandaged and chances of complications are much reduced.
The radial route for angioplasty is more economical and even trims hospital costs because patients are discharged sooner.
The new technique is also preferred as patients are more comfortable post-procedure as compared to the traditional femoral approach.
Also, post-operative vascular complications are less enabling the patient to recover more quickly.
However, the new technique needs extra training and very few professionals are proficient in conducting this surgery.
Dr Rod Stables, stated, “Too few cardiologists are trained in this technique.
“They have preferred the femoral artery because it provides a larger blood vessel, making it easier to guide their instruments through, and some patients require bulkier catheters which can’t fit through the radial artery.”
As the patient is in and out of the hospital, the same day and may return to work after few hours, or at the most the very next day, for most, radial angioplasty is as simple as going to the dentist to have a tooth extracted.
A 63-year-old patient, Paul Hope, who recently underwent the operation after suffering an acute heart attack on Valentine Day stated, “It was painless and relaxed. I lay on the operating table and rolled up my sleeve.”