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Transradial Cardiac Catherization

Transradial cardiac catheterization is gaining popularity locally as an alternative to the traditional approach for both diagnostic and interventional (angioplasty) heart catheterization procedures, according to Amy Jetton, Director of Cardiovascular Services at Washington Regional's Walker Heart Institute. Walker Heart Institute was the first healthcare provider in Northwest Arkansas to develop a dedicated program to make diagnosis and treatment easier for heart patients by offering this less-invasive procedure for cardiac catheterization, and has already performed more than 300 transradial catheterizations.

In traditional cardiac catheterization, the insertion point for the catheter is the femoral artery in the patient's groin-an area that is sometimes difficult to access and may be prone to excessive post-procedure bleeding. Patients undergoing procedures through the groin (transfemoral) generally must lie flat for 2-6 hours after the procedure, while a nurse or technologist applies pressure for 10-30 minutes to prevent bleeding at the access point.

With the transradial approach, the catheter is placed in the radial artery in the patient's wrist, which reduces complications from bleeding by 75 percent. Since there is no need for the patient to lie flat after the procedure, transradial recovery time is shortened to about two hours. "Once access is made, whether transfemoral or transradial, the procedures that follow are virtually the same," Jetton says. "The difference is in the patient's ease of recovery."

 "Patients treated using transradial access generally experience less pain, and are able to walk around after their procedure sooner than patients treated using traditional femoral access," says Geetha Ramaswamy, M.D., who has been performing transradial cardiac catheterization at Walker Heart Institute since 2009. Walker Heart Institute joins major university medical centers like Duke and Stanford in offering this procedure.

For many patients, the idea of access through the sensitive groin area is enough to cause apprehension. "I was anxious at first about having catheterization," says Steve R., a carpenter and recent transradial catheterization patient. "But I felt much better about it when I learned that Dr. Ramaswamy could use the radial approach. I had a good recovery, and was back at work two days later without any pain."

Robert B. already had great confidence in the technology and skilled care team at Walker Heart Institute, since he works at Washington Regional as an electrician. Still, he was surprised at how comfortable he felt throughout his transradial cardiac catheterization. "I was able to be aware of what was going on during the procedure, and I didn't have any pain. Within two hours, I got to go home."

Though considered fairly new in the U.S., the transradial approach has been performed by physicians for more than 20 years, Jetton says. It is widely used in Canada, Europe and Asia, accounting for up to half of all coronary angiograms there.

Dr. Ramaswamy, who trained in transradial cardiac catheterization during her interventional cardiology fellowship at Yale University School of Medicine in New Haven, Conn., says an increasing number of patients at Walker Heart Institute are choosing the new approach. "When patients learn about the benefits of using transradial access, they immediately want to find out if they are candidates for it," she says.



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