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Transradial heart catheterization
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Transradial heart catheterization

  I have been advised I require a heart catheterization to better diagnose
  the level of blockage in one artery.  A regional hospital is now offering
  the transradial approach to heart catheterization.  It sounds as though it
  is a new procedure that offers easier and shorter recovery time from the
  procedure.  This is, of course, attractive to me, but is the procedure as
  safe and reliable as the conventional method?
  On the other hand, the group I am working with are, in some instances, "plugging"
  the entry site of the conventional method reducing and minimizing the time and
  weight and positional difficulty that this method has required.
  Would you shed some additional light on this subject?
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Dear Charley, thank you for your question.  Transradial cardiac catheterization
is a relatively new way to perform a cardiac cath that is being offered by some
cardiologists across the country as a way to decrease recovery time after a cath.
During this procedure, the radial artery in the wrist is accessed with small catheters which are then positioned in the openings of the coronary arteries to perform the cath by injecting dye to opacify the arteries.  Normally, a cardiac catheterization is done via the femoral artery in the groin which is a much bigger artery than the radial artery and therefore, larger catheters (which are easier to manipulate) can be used to perform the cath.  Originally, caths were performed via the brachial artery which is in the elbow between the wrist and the shoulder.  A radial artery cath occurs further downstream in the same artery as the brachial artery.  Studies have shown similar complication rates between femoral and radial caths and the diagnostic portion of the cath can usually be performed via the radial approach if the artery is big enough to accept the catheter.  After the cath, the recovery time from a radial cath is usually 20 minutes of manual pressure and then discharge within an hour.  Since the femoral artery is much bigger and harder to compress, the recovery time is 20 minutes of pressure followed by 4-6 hours of bedrest to allow the hole in the artery produced by the cath to completely heal.  New closure devices have been developed to seal the hole in the femoral artery after a cath to decrease the recovery time.  For example, an Angioseal is a collagen plug inserted above the artery after a cath that decreases the bedrest to 2  hrs. while a Perclose device allows the cardiologist to directly suture the hole in the femoral artery to decrease the bedrest to less than 30 minutes.  Results from these devices are good but depend largely on the skill of the operators using them.  In our cath lab, we commonly use the femoral artery because many patients undergo angioplasty immediately after the cath and the catheters used for an angioplasty are bigger and can only fit in the femoral artery.  Thus, you should talk to your cardiologist to find out what their plans are once they do the diagnostic cath and what their experience is with closure devices and transradial catheterization.  I hope you find this information useful.  Please write back with further questions.
Information provided in the heart forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physician.

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