A New Way To Your Heart: Transradial Catheterisation
Paras Institute of Cardiac Sciences uses the transradial technique for performing cardiac catheterization. This uses the radial artery in the wrist instead of the femoral artery in the groin to gain access to arteries leading to and into the heart. Termed as ‘Transradial Access’ this gentler approach has a number of advantages over the femoral cardiac catheterization procedure.
What is Cardiac Catheterization?
Cardiac catheterization is a procedure used to diagnose and treat conditions of the heart.. People who experience symptoms of heart disease such as chest pain, or an emergency event such as a heart attack, must undergo cardiac catheterization to determine the level of heart damage or disease. The procedure also may be used to open blocked arteries that limit blood flow through the heart and prevent oxygenated blood from travelling properly to the body. Cardiac Catheterization is performed on more than one million Indians each year. A long, thin tube called a catheter is inserted into the body through various routes, and guided to the heart. Here, it is used to detect any blockages or abnormalities; to take a muscle or blood sample; Measure blood pressure and oxygen levels; Repair or replace heart valves; Detect and repair congenital heart defects; Perform an angioplasty or balloon valvuloplasty and correct arrhythmia.
What is Transradial Coronary Catheterization?
For many years, the preferred entry point for a cardiac catheterization has been in the groin area through the femoral artery. However, an innovative option is called radial catheterization, which involves insertion of the catheter through the radial artery in the wrist. The transradial approach reduces the risk of bleeding, speeds up the recovery process, and improves patient comfort. The lack of skilled interventional cardiologists is the main reason for its limited use in India. In Paras Hospitals, experts perform 90% of the cardiac interventions using the transradial method. Patients can avail of this internationally acclaimed procedure at a lower cost.
What are the advantages of the ‘Transradial Access’?
- Faster recovery
- Easier site access-wrist
- Less pain and bleeding
- No restriction of movement during procedure
- Fewer complications and lower risk of infections
- No requirement of blood transfusion
Which patient would derive the maximum benefits?
- Patients with respiratory and pulmonary issues
- Patients with spine problems including back pain who have difficulty in maintaining one position for hours.
- Patients who are obese
- Elderly patients
How does the transradial access benefit women?
Performing a cardiac operation through the transradial route is of enormous psychological benefit to conservative Indian women. Femoral access through the groin region during cardiac catheterization is a cause for apprehension in the majority, who would much rather opt for the transradial access routine through the wrist.
In which patients should transradial access catheterization be avoided?
Not everyone is eligible for a radial artery catheterization. To be a candidate, patients must have good blood supply to their hands, through both the radial artery and the ulnar artery.
Will it cost more? No. Despite its multiple benefits, the cost of having a transradial catheterization is the same as that using other methods.
Benefits of the transradial approach
Arterial access is a crucial step of percutaneous cardiac procedure and poses the most common challenge for an interventional cardiologist during a catheterization procedure. The patient may also experience an adverse response in the form of a vagal reaction or painful spasm, increasing time taken for procedures and leading to significant complication. Percutaneous coronary intervention (PCI) is usually performed via the femoral, radial arteries and brachial approach. But the transradial approach, which is via the wrist, offers many advantages. The wrist approach is preferable in many cases because it is safer, has less access site complications like bleeding, enables a quicker recovery for patients who can go home very shortly after the procedure.
Comparison of Tranradial & Femoral Access Cardiac Cathterisation:
|TRANSRADIAL ACCESS||FEMORAL ACCESS|
|Easier access site- wrist.The patient is more comfortable as the access site is approachable.||Access site- groin.Patient feels uncomfortable as the groin is the private area.|
|Less bleeding.||Can lead to bleeding|
|Lesser chances of infection||More chances of infection due to more bleeding|
|Lesser pain- as a smaller compression device is used.||More pain- as the femoral site has to be compressed for many hours to stop the bleeding.|
|Quicker recovery- patients can resume activities after 2 hours of the procedure||Patient has to be hospitalized for more than 6 hours post procedure|
|No restriction of movement post procedure||Patients has to lie still and is often restricted from movement|