Getting to the heart through the wrist
The development of non-surgical procedures over the past 20 years has been one of our most remarkable advances in the treatment of heart disease.
Instead of opening the chest and spreading the rib cage, we increasingly have been able to deliver medicines and devices to the heart through soft, flexible tubes — called catheters — inserted through small needle punctures in the skin and guided through the arteries.
These catheter-based methods allow us to avoid the pain, scarring and long recovery from open-heart surgery. They may be used for diagnostic purposes to detect heart disease, and for treatment purposes to open blocked arteries and keep them open with devices such as balloons and stents.
Typically, we have inserted these tubes through an artery in the leg, but advances in catheter design have made it easier to enter the body through an artery in the wrist. Entry through the wrist reduces the risk of bleeding, increases patient comfort and speeds recovery.
After entry through the leg, patients must lie flat for up to six hours to prevent excessive bleeding. After entry through the wrist, we simply control bleeding with a pressure band on the wrist. Patients are able to get out of bed, walk around and go home sooner. Entry through the wrist often is less complicated in obese patients whose fatty tissue makes it difficult to access the leg artery.
While procedures through the artery in the wrist have been the preferred method in many countries for many years, they are gaining wider clinical acceptance in the United States due to the advantages we’ve mentioned.
To determine if you are a candidate to have a catheter inserted through your wrist, we test to make sure the arteries in your hand are open and healthy. Some devices that need to be used, or medical conditions, may require entry through the artery in the leg. The risks and benefits of the two approaches vary according to the individual and should be discussed with your cardiologist.
Grady Memorial Hospital patients may be candidates for catheter-based procedures including radial access angioplasty to diagnose many heart problems. If more advanced treatment is needed, Grady patients can make a smooth transition to one of our OhioHealth partners in Columbus, Grant Medical Center and Riverside Methodist Hospital. The heart and vascular physicians who see patients and perform heart services at Grady also practice at Grant and Riverside, allowing them to follow patients through every step of treatment.
Dr. Tejas A. Mehta is a board certified interventional cardiologist with HeartCare and an active member of the Grady Memorial Hospital Staff.