What are advantages and disadvantages of radial-artery catheterization?

In the past, most doctors performed heart catheterizations through an artery in the groin. However, this procedure has improved because doctors can now go through the radial artery in the wrist. A tube is inserted into the artery through the skin, and then through that tube doctors can put longer tubes to get up to your heart to inject dye.

The groin approach meant a person had to lie flat on his or her back for up to eight hours after the procedure to keep the incision site from bleeding. With the wrist approach, you basically have a little wristband that you wear from between 90 minutes to three hours. People who have had both approaches say they vastly prefer the wrist approach to the groin approach because it's less painful. Further, radial artery catheterization gets you up and walking quicker and out of the hospital sooner. And having the procedure done through the wrist rather than the groin is  associated with a lower mortality rate for people having a heart attack.

Although rare, bleeding complications—both internal and external—occur in a small percentage of cardiac catheterization patients and can be serious, even deadly. These complications are virtually eliminated when the catheter is inserted through the radial artery of the wrist instead of the groin area, says UCLA cardiologist William Suh, M.D.

One downside to the radial approach is the potential for painful muscle spasms in the area surrounding the artery, though in the majority of patients, these can be prevented with medications. The radial artery can also close after the procedure, causing blood clotting to occur, so blood thinners are given during the procedure.

Cardiac catheterization is most commonly performed by entering the circulatory system through a blood vessel in the groin (the femoral artery). However, many patients have their procedure performed through the radial artery which courses through the wrist.

Catheterizations through the radial artery have several advantages:

  • Patient comfort is significantly improved. Because the entry site is at the wrist, patients are able to sit up and walk immediately after their procedure whereas patients having their procedures via the femoral artery approach will often require up to six hours of bed rest. As result, there are fewer issues with back discomfort and patients are able to eat comfortably after their procedure.
  • Patients who are scheduled for same day discharge can be discharged at an earlier time period than if their procedure was performed through the femoral approach since the post-procedure recovery is shorter than with the femoral approach.
  • The radial approach is safer than the femoral approach for the majority of patients undergoing cardiac catheterization. Because the artery is smaller and very close to the skin, important bleeding is significantly reduced compared to the femoral approach.

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