Angioplasty: Radial Approach

Dr. Raghuraman Vidhun, Interventional Cardiologist at Saint Mary's Hospital and Waterbury Hospital answers your questions about angioplasty with a radial (wrist) approach.

What is an angioplasty with a radial approach?

Dr. Vidhun: An angioplasty is a procedure to improve blood flow through the arteries in the heart. An angioplasty can relieve your chest pain and help prevent your arteries from narrowing further. An angioplasty can also limit damage to the heart muscle during a heart attack and improve survival. During an angioplasty with a radial approach (sometimes called a trans-radial coronary intervention) your interventional cardiologist inserts a small catheter into the radial artery in the arm as opposed to the groin which is the most common approach used in the United States.

The catheter travels through the body to the narrowed artery in the heart which allows the physician to provide treatment to a blockage in the heart with a balloon or stent. Although physicians have been performing angioplasties since the 1980s, angioplasty with a radial approach is a newer technique.

What are the benefits of this approach to angioplasty?

Dr. Vidhun: Angioplasty with a radial approach may provide the patient with increased comfort immediately following the procedure because the patient may sit up and move around relatively quickly after the procedure. There is virtually no risk for bleeding complications after the procedure. However this approach may not be appropriate for all patients and should be discussed with your physician.

Who is a candidate for the radial approach to angioplasty?

Dr. Vidhun: Patients who have had coronary artery bypass surgery, have kidney disease and/or who are on dialysis, are not ideal candidates for this approach to angioplasty. Your physician may do a simple test to assess the blood flow in the hand as adequate blood flow in the hand is necessary for this approach. If normal circulation is present you may be eligible for angioplasty done via the wrist.

In your experience, what kinds of patients are well suited to and prefer this technique?

Dr. Vidhun: Patients who benefit the most are those patients who are overweight and carry a high risk of bleeding complications due to difficulties accessing the femoral artery. Patients with chronic back conditions who cannot lie still for prolonged periods of time may find this approach more comfortable in terms of recovery time. Usually, patients can be up walking within 1 to 2 hours of having the procedure. Typically patients express increased comfort and a quick recovery.