Interventional cardiologist accesses coronary arteries through radial artery on the inside of wrist

Jan 23 2010

In an innovative new procedure, interventional cardiologist Ramesh Mazhari, MD, is one of only a few in the Washington, DC, region to access the coronary arteries through the radial artery on the inside of the wrist.

How Cardiac Catheterization Works
In cardiac catheterization, doctors thread a thin catheter to the coronary arteries in the heart. Using X-ray movies, they look for signs of heart disease and determine the size and location of fat and calcium deposits that narrow the openings in the arteries. Doctors also may use tiny balloons and stents to open blocked vessels and restore blood flow to the heart.

In traditional cardiac catheterization, doctors reach the heart through a catheter inserted in the large (femoral) artery in the thigh. After this procedure, patients usually stay at the hospital overnight and must lie in bed for four or more hours to prevent bleeding from the femoral artery. However, when the catheter is inserted into the radial artery on the inside of the wrist, patients typically can sit up immediately after the procedure.

Fewer Risks, Less Bleeding
Transradial catheterizations through the wrist are routinely done in Asia and Europe, where it's estimated that as many as 50 percent of procedures are performed this way. Dr. Mazhari has completed more than 200 transradial cardiac angiography and angioplasty procedures.

"This technique almost completely eliminates the risk of major bleeding," Dr. Mazhari says. "Radial arteries are smaller and closer to the surface, and patients wear inflatable wrist bands that compress their arteries to prevent bleeding."

Advantages for Older Patients
Transradial catheterization is especially appealing to older patients, and patients with chronic back pain and obesity, who would have difficulty lying down for hours after traditional cardiac catheterization.

Patients who have advanced kidney disease, previously had coronary artery bypass surgery or have complex cases that require larger catheters may be better suited to the femoral approach.

"We've had great feedback from patients and nurses," Dr. Mazhari says. "Patients can sit up and walk within minutes, and they recover faster."