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Heart Procedures Performed Through the Wrist: January 5,2012

It’s been standard practice to thread a catheter through an artery in the groin when performing a cardiac catheterization. Now doctors are adjusting their sites on this diagnostic procedure.

“An improvement in techniques and an improvement in types of equipment that’s smaller allows us to more easily and more safely go in through a puncture holed in the radial artery the smaller artery in the wrist,” says Dr. Robert Chazal, a cardiologist with Lee Memorial Health System.

So instead of making a deep puncture in the groin, doctors can make a superficial poke in the wrist. It is more accessible and in some cases, safer.

“They can actually reduce the risk of bleeding because the artery is closer to the surface as opposed to a deeper artery in the leg,” says Dr. Chazal.

Doctors perform about 1.3 million cardiac catheterizations a year in this country. Up to 90% are done through the groin. Going through the wrist is technically more challenging, but from a patient’s point of view, it’s worth the effort.

“Most of the patients like it if the catheterization can be done through the wrist because after the catheterization instead of having to lie flat because of the puncture hole in the groin they actually can sit in a chair if they wish. The recovery time is quicker and certainly in terms of walking or riding a bicycle or that sort of thing people are more comfortable doing it the next day,” says Dr. Chazal.

As equipment continues to evolve, doctors are moving from diagnosing heart conditions through the wrist to inserting angioplasties and stents. Going through the wrist may not always be the right choice.

“In certain circumstances if an artery has a severe blockage, especially if the person is experiencing a lot of symptoms or is in the midst of a heart attack, there can be a tremendous benefit by opening that artery up,” says Dr. Chazal.

When considering the wrist alternative, it’s best to arm yourself with the advice of your physician.