Radial Artery Catheterization Makes A Comeback
Procedure Provides Comfort and Convenience, Reduces Complications of Cardiac Intervention
Sanford, FL When the chest pain began on Friday afternoon while he was digging a trench at his home in Lake Mary, Randy Floyd called his doctors office knowing what might lie ahead. With a history of coronary disease, he was very in tune with his body and the warning signs of heart issues. So when the physician assistant told him to head directly to the emergency room, Floyd began preparing himself, remembering his two previous cardiac catheterization procedures and dreading what was to come.
When he arrived at the emergency room at Central Florida Regional Hospital with unstable angina, his doctors concluded Floyd had not suffered a heart attack, however a catheterization would be necessary to diagnose and, if possible, treat the cause of his chest pain. The good news for Floyd was that his catheterization could be done using a technique that would minimize his discomfort and have him back to normal activities more quickly than what he had previously experienced.
The radial approach for heart catheterization is making a comeback because of new tools and advancements in the devices and medicines that are used to open blocked arteries. Radial catheterization can reduce the risks that were typically associated with the femoral approach. Best of all, there is much less discomfort for the patient who, typically, can return to normal activities within a few days.
Most patients requiring catheterization should be candidates for the radial approach, said Carlos Grullon, M.D., an Interventional Cardiologist at Central Florida Regional Hospital. By accessing the heart through the radial artery, we have better control of bleeding and the patient can get up, walk, eat and move around soon after the procedure. Not only are they more comfortable but, because they are ambulating sooner, they have less complications.
Following the traditional catheterization through the femoral artery, patients leave the cath lab with a sheath in the femoral artery. Because patients receive blood thinners prior to the procedure, they must be monitored closely to ensure bleeding is controlled. This can require a hospital stay with up to 10 hours or more of bed rest while applying direct pressure, depending on the amount of anticoagulants the patient received.
Radial artery catheterization offers better control of bleeding. The patient is able to sit up immediately following the procedure and direct pressure is applied using a clear radial band which makes it easy for nurses to monitor bleeding. The band is inflated to hold pressure and as time passes the pressure is decreased. As long as there is no bleeding, pressure continues to be decreased and eventually the band is replaced by a pressure bandage.
For Randy Floyd this meant going home the day after his catheterization. Three days later he was back at work.
I like to be active. I like to be up and around, Floyd said. Following my two previous catheterizations, I had to lie down or sit still for a week. This time I was back to my normal routine the day after my procedure.
The radial approach is good for a lot of reasons, said Dr. Grullon. In addition to increased patient comfort and less complications, eventually it will shorten hospital stays, providing an economic impact on patient care. I suspect there will be a time very soon that the patient who has a cardiac intervention will go home the same day and will not require a hospital stay.