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Cutting Edge

Title
Getting to the heart from the wrist
Date
04/13/2010
Article
Cardiologists practicing at CAMC and employees in the cardiac catheterization lab recently trained on the transradial approach to perform cardiac caths. Instead of using the femoral artery in the groin as is the traditional procedure for a cath, the transradial approach uses the radial artery in the patient’s wrist.
The catheter is then threaded through the artery to the heart and its chambers.

“From a historical standpoint, we’re going ‘back to the future,’” said Stephen Lewis, MD, medical director of the cath lab at CAMC. “The radial approach was designed about 20 years ago, but has been
more widely used in other countries because most cardiologists in the United States are trained using the femoral approach. Information regarding improved patient outcomes has increased the interest for
this approach.”

“Once you are in the artery, the procedure is performed in the same way as a traditional cardiac cath,” said Lisa Hoffman, director of the cardiac cath lab/post cardiac cath unit at CAMC. “Benefits of doing
the procedure this way include less recovery time, and the patient can move immediately after the procedure.”

After a cardiac cath is done through the femoral artery, the patient has to lie still for several hours to prevent bleeding from the entry site.

“There are less bleeding complications and less vascular problems when using the radial site,” Lewis said. “It’s also a matter of patient preference and comfort level.”

To prevent bleeding from the wrist site, a device called a TR Band is used to apply pressure to the entry site after the procedure is completed. The band is clear, so caregivers can see the entry site and quickly access it if there is any bleeding.

“The band compresses the artery to allow blood return without affecting nerve structure and is usually removed within two hours of the procedure,” Hoffman said.

Most patients are well-suited to the transradial cath procedure. “It’s only around 7 percent of the time that you can’t use the radial approach,” Lewis said. “It’s particularly well-suited to patients who have a large body mass index or patients with peripheral artery disease.”




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