Reaching the heart through the wrist, not the groin

9:50 PM, Aug 2, 2011   |    comments
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By Kay Quinn Healthbeat Reporter

St. Louis (KSDK) - There's a significant new twist to the way doctors place stents in the heart.

More than a million cardiac catheterizations are done in this country every year. Doctors use a wire, and go through an artery in the groin to reach the heart to get information about blockages, or even treat those blockages.

But for the first time in this country, doctors are increasingly accessing the heart during cardiac catheterization through the wrist instead of the groin.

"It's just miraculous to me," says Sam Wright, a cardiac catheterization patient.

61-year-old Wright has had four cardiac catheterizations through the groin, and finds the hours after the procedure the most uncomfortable.

"You couldn't move," says Wright, "somebody was holding the wound, the puncture area for about 20 minutes, 30 minutes, to stop the bleeding initially and then whatever they put on it. But I think you had to lay there I think it was 8 hours at least."

Then his doctor suggested something different: radial artery catheterization, or going in through the wrist.

"We can not only do cardiac catheterization through the radial artery but we can put in stents, and do balloon angioplasty, and all that through the wrist as well," says Dr. David Dobmeyer, a cardiologist at St. Anthony's Medical Center.

The advantage is a significant. While studies have shown no difference in the number of deaths between the two procedures, going in through the wrist dramatically cuts the risk of bleeding.

"It's smaller and the way that it is situated in the wrist anatomically there's no place for the blood to go other than out through the skin," says Dr. Dobmeyer.

The radial artery approach has been done in Asia for the past 10 years. It's only been done in this country for the past two or three and only about three percent of all catheterizations are done this way.
Anyone having a heart attack, in unstable condition or who has had a bypass in the past can't have it done.

But Dr. Dobmeyer predicts radial artery catheterization will explode in popularity in the future, because the tubes used are much smaller than the traditional procedure.

Generally, 2.5 millimeters in diameter, maximum, which is a little bit larger than the lead in a lead pencil," says Dr. Dobmeyer. "The stents are smaller the balloons are smaller and so we're no longer using the femoral artery to accommodate big equipment."

"It's mindboggling," says Wright. "I was out of here within I think three hours four hours."

A balloon on a wrist band like this helps the radial artery close and heal, and many patients walk out of the procedure room on their own.


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