Improving Cardiac Catheterization

More than 1 million cardiac catheterizations are per­formed in the United States annually, and most of these procedures are performed via the femoral arter­ies through the groin. With transfemoral catheterization, patients must lie flat for 4 to 6 hours after the procedure. This is necessary to ensure the puncture site reaches hemostasis and to prevent bleeding complications. Transfemoral cath­eterization can be painful for patients once the procedure is completed because there is a need to compress the artery for 20 minutes manually. The decreased mobility after the proce­dure can also lead to other problems during hospitalization. An alternative approach that is being used by more and more clinicians nationwide is transradial catheterization. In these procedures, the coronary arteries are accessed via the wrist, enabling patients to become mobile almost immediately after the procedure. After the surgery, patients can walk, sit upright, use the bathroom, and eat and drink more quickly than with the transfemoral approach. The transradial approach has also been associated with lower complication rates and increased patient comfort. The complication rate for the transfemoral approach varies but can be as high as 3% to 5%. For transra­dial approaches, the rate drops to less than 1%. In addition, the bleeding associated with transfemoral approaches can be more dangerous than for that of transradial procedures. History of Transradial Catheterization The first transradial diagnostic catheterization was per­formed in the late 1980s in Europe. In 1993, a research team in Amsterdam began using the technique for interventional procedures. In recent years, the methods for catheterization have become increasingly enhanced. Some interventional cardiologists view transradial catheterization as the optimal choice for a...