the transradial option

According to the National Cardiovascular Data Registry, there are more than 1 million cardiac catheterizations performed annually in the United States. The vast majority of those are transfemoral caths with transradial caths comprising only 16 percent of that number. But that latter percentage may be on the rise.

“Transradial caths have been around since the 1990s. The procedure has been used more in Europe than in this country,” says Dr. Jigar Patel, an interventional cardiologist at Ocala Health. “That may be because transfemoral caths are what have been primarily taught in medical schools. But that is shifting, and the tranradial cath procedure is being taught more and more.”

During a cardiac catheterization, a long, thin, hollow tube known as a catheter is inserted through a blood vessel and threaded to the heart with the help of special X-rays. In transfemoral caths, this access is through the femoral artery deep in the groin area. In transradial caths, it is the much smaller radial artery in the wrist that is utilized. Both procedures are used for diagnostic and interventional purposes, including taking X-rays, clearing artery blockages and inserting a stent to keep an artery open.

“With a transfemoral cath, there is a risk of abdominal bleeding. And following a transfemoral cath, patients have to lay flat for hours to prevent bleeding at the insertion site. Unfortunately, bleeding complications from transfemoral caths can be disastrous and even life-threatening,” says Patel. “With a transradial cath, there is no need for the patient to lay flat for hours, and bleeding complications are greatly reduced. Patients enjoy a shorter and easier recovery time. And in most cases, I feel confident in being able to send my patients home the same day without the worry of complications.”

Of course, Patel notes, “All medical procedures have risks, including transradial caths.”

There can be pain and swelling at the catheter insertion site; nerve damage to the dialysis, someone who has had hand/wrist surgery or the elderly with compromised radial arteries, a transradial cath may not be an option.

“In my practice, my preference is to perform catherizations transradially,” says Patel. “I use the transradial cath 70 percent of the time. I think interventional cardiologists will continue to be trained in and use transradial caths.”