Each year an estimated three million coronary angioplasties are performed in the United States to look for blockages in coronary arteries and to open them with a tiny balloon. Currently the more popular procedure involves using the large femoral artery in the groin. But a new study shows that using the smaller radial artery in the wrist as the entry point is safe and may actually have fewer complications. Plus, this technique is more comfortable and convenient for the patient.
Angioplasty involves the insertion of a probe equipped with a small balloon and a mesh-like framework. The device snakes its way through arteries until it reaches a blockage in one of the coronary arteries, which deliver blood to the heart muscle. Then the damaged area is propped open, and the scaffolding is left in place.Traditionally, the insertion point of choice has been the femoral artery because its big and easy to get to. But its also a deep artery, even more so in patients who are overweight or obese, so theres more potential for bleeding complications.In fact, in emergency rescue cases where the patient is suffering a heart attack as the result of total blockage of the coronary artery, some medical experts are now saying the wrist procedure may be the best way to go.
In the past, using the wrists radial artery had been controversial, mainly because the radial artery is smaller than the femoral artery so using it requires greater skill. Only in the last five to 10 years has the equipment become small enough and more miniaturized so that the radial artery has now become possible. And now theres adequate data to compare the two approaches.The four-year landmark study, headed by Dr. Sanjit Jolly of McMaster University's DeGroote School of Medicine in Hamilton, Canada, studied 7,021 patients at 158 hospitals in 32 countries. The patients, undergoing angiography or angioplasty, were randomly assigned to use the femoral artery (groin) or the radial artery (wrist). The trial showed that both procedures are safe but that there are advantages to the radial artery, with similar success rates.For example, the results showed there were fewer bleeding complications with the radial artery and the procedure was more patient-friendly; it allowed patients to return to normal activity more quickly than the femoral artery procedure.The results were presented at the American College of Cardiology conference in New Orleans and the study is also being published in The Lancet.Robin Westen is ThirdAges medical reporter. Check for her daily updates.See what others have to say about this story or leave a comment of your own.