Interventional cardiologists in the United States perform over one million cardiac catheterizations each year. Cardiac catheterization, which provides access to the arteries that supply blood to the heart, is generally performed by going through the femoral artery in the groin. But at Crouse Hospital, the cardiac care team almost exclusively performs heart “caths” by going through the radial artery in the wrist instead.
This approach – called “transradial access” – has been gaining popularity in the medical community, with the technique being taught to cardiologists in specialty conferences and short courses throughout the country. The procedure offers a number of advantages over the femoral option, including reduced complications, shorter hospitalization and significantly increased comfort for the patient.
Joseph Battaglia, MD (pictured), Crouse Hospital's Medical Director of Cardiac Care Services, notes that “the complication rate is a lot less when cardiac catheterizations are done radially, especially at Crouse where the cardiac care team has over a decade of experience using the technique.” Dr. Battaglia was one of the first interventional cardiologists in Syracuse to routinely perform cardiac caths using the radial technique and has been using it almost exclusively since 1997.
The complication rate is lowered post-procedure primarily because the risk of bleeding is significantly less than with the femoral technique. In cardiac caths that go through the groin, it can be difficult to tell if there is internal bleeding. The wrist, however, is so small and easy to access that any post-procedure bleeding is easily identified and treated, according to Dr. Battaglia.
“Patients who have the radial technique express great satisfaction with the procedure,” says Lorissa Plis, RN, Manager, Cardiac Care Services. “They appreciate being able to sit up and move around almost immediately after, unlike patients undergoing the femoral approach, who must be on bed rest for a minimum of two to four hours.”
Unlike many cardiac care centers, which are just beginning to explore the advantages of the radial approach, Crouse's lab has the equipment and system in place to quickly and effectively perform the procedure under any circumstance. In fact, Crouse cardiologists perform nearly 90 percent of their caths using the transradial option – for both emergent and non-emergent cases.
Anil George, MD, an interventional cardiologist who joined the Crouse team in 2008, notes that “a minority of doctors are performing radial catheterizations,” and that observing the success Dr. Battaglia has had with the technique encouraged him to learn it.
Additionally, with the increased interest in the procedure nationally, new technology has emerged, which allows interventional procedures to be performed with catheters that are small enough to fit through the radial artery. For Dr. Battaglia and Dr. George, this technology has decreased the time they spend performing the procedures, further improving the patient experience.
Crouse has invested in special reclining chairs for patients to recover in after having a transradial cardiac cath procedure. “The chairs greatly improve the experience for patients, who love to get out of their hospital bed into something more comfortable while they eat lunch, watch TV or chat with family before being discharged,” says Plis. “Patient comfort is of utmost important to us. This procedure and unique recovery arrangement provides our patients with the best in comfort and medical care.”
For more information about cardiac care at Crouse, call Lorissa Plis, RN, at 315/470-8707 or visit us at crouse.org/cardiac.