Doctors from around the world are unclogging blocked arteries in the heart by entering through blood vessels in the wrist instead of the groin, and U.S. doctors are slowly following suit, a new study reveals.
The study, published in the journal Circulation, suggests that entering the radial artery in the wrist is associated with fewer bleeding complications than the traditional way through the femoral artery in the groin.
Lead author Dr. Dmitriy Feldman, an assistant professor of medicine at Weill Cornell Medical College, New York Presbyterian Hospital department of medicine, said:
“Traditionally, femoral access has been taught and used in the United States for PCI, whereas the radial approach is frequently used in Europe.”
This artery-unblocking method is known as percutaneous coronary intervention (PCI) or coronary angioplasty. During the procedure a narrow area of a heart artery is widened by angioplasty or a related method.
Radial PCI can also give the most significant advantage over groin access for patients who are at highest risk for complications, including those who are 75 or older, women, and individuals with acute coronary syndrome (ACS).
Dr. Feldman and his team examined data on close to 3 million artery-opening procedures and found that bleeding complications occurred in 3% of the radial artery procedures versus 6% of femoral artery procedures.
More frequent use of the wrist-route procedure could increase safety of the artery-opening operations. Bleeding complications are important factors in these procedures, because many people who endure them are on blood thinners, making it more difficult for bleeding to cease after surgery.
The authors pointed out that the radial artery is smaller and located near the skin’s surface, unlike the femoral artery, this makes it easier to stop bleeding.
The investigators assessed artery-opening procedures performed at 1,400 U.S. centers between 2007 and 2012. By December 2012, one of every six procedures was being conducted via the wrist’s radial artery.
This suggests a 13-fold increase from 2004-2007, when less than one of every 50 PCIs was completed through the radial artery.
The authors also found that use of radial PCI is much more frequent at academic institutions and centers in New England, than anywhere else in the U.S.
In 2011, a study in JAMA revealed that 9.4% of percutaneous coronary intervention patients find themselves back in the hospital within a month. Additionally, these patients had an increased risk of death within one year of the procedure.
Written by Kelly Fitzgerald