Cardiac catheterization to detect and correct blockages in the heart’s coronary arteries is usually done after a patient experiences chest pain or shows abnormal results on an EKG or a stress test. During the procedure, an X-ray detectable dye is injected through a catheter into the coronary arteries to locate areas where blood flow is restricted. If a blockage is detected, a balloon can be inserted through the catheter to expand the artery, and/or a stent can be inserted to stabilize the artery, restoring blood flow.

According to Jaikirshan Khatri, MD, a cardiologist on the Medical Staff of Southwest General, 95 percent of all coronary catheterization procedures in the U.S. are done by feeding the catheter into a patient’s femoral artery in the groin. Although the procedure has been widely successful, it is occasionally associated with heavy bleeding and requires restricted activity for days afterward. Entering through the radial artery in the wrist instead of the femoral artery is a safer, more convenient method of coronary catheterization, explains Dr. Khatri. In fact, he performs 95 percent of his coronary catheterizations through the wrist.

“The radial approach is more convenient for the patient,” says Dr. Khatri. “No bed rest is required afterward. Patients can sit up and eat immediately after the procedure and, unless they requested sedatives, they can literally get off the table and walk to the recovery room on their own two feet. There are really no activity restrictions—they can resume normal activity the next morning.” In contrast, the femoral approach, because it involves penetrating a major artery, requires 15 to 30 minutes of manual pressure by a nurse to control bleeding, and it requires two tosixhoursofbedrestanduptoaweekof activity restrictions.

Long-term, the comparative safety of the radial approach is even more important than convenience. Dr. Khatri notes that catheterization through the radial artery eliminates one of the two major predictors of death within a year after a coronary catheterization.

“Death following a coronary catheteriza- tion is rare, but when it occurs, it is usually related to a heart attack following the proce- dure, or major bleeding,” he says. “Using the radial procedure, we eliminate one of those two predictors. There is little or no bleeding involved in the radial catheterization.”

Because the radial artery is significantly smaller than the femoral artery, cardiologists like Dr. Khatri go through extensive additional training to master the procedure. “It is harder to do, and it takes a lot of physicians outside of their comfort zone,” Dr. Khatri says. “But the benefits to the patient are worth it. Most people are just amazed when we are finished with the procedure.”

Dr. Khatri says the physicians at Cardiovascular Medicine Associates perform about 350 to 400 radial catheterization procedures every year.

In addition to coronary catheterization, the radial approach has been adapted to other catheterization procedures as well, such as those for carotid arteries and arteries in the kidneys.

“A lot more patients are beginning to enjoy the safety and convenience of radial catheterization,” Dr. Khatri says.

To learn more, contact Southwest General’ s Health Connection at 440-816-5050.