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An Access to the Heart Through Your Hand

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April 30, 2018 1 211 4 minutes, 36 seconds read
Picture1_0 - Max Hospital
Principal Consultant
Cardiac Sciences, Cardiology

Coronary artery disease is a condition that causes impaired blood flow in the arteries that supply blood to the heart. It is also known as coronary heart disease (CHD), and if uncontrolled it can lead to a heart attack. It is a common heart condition and also one of the leading causes of death. Hence, it is crucial that coronary artery disease must get diagnosed and treated as early as possible. Seeing a cardiologist in Delhi should be the first step if anyone is suspecting symptoms of coronary artery disease.

Clearing a clogged artery in the heart once required a full-blown operation such as open-heart surgery. However, today interventional procedures can treat coronary artery disease and open up blocked arteries with minimal intervention.

Angiography is a minimally invasive option that is used to see which blood vessel(s) is obstructed and requires repair. Angioplasty, on the other hand, is the method of widening the narrowed arteries after knowing the ones that are blocked.

Typically, angiography is done through the femoral or Leg artery in the groin. A catheter is inserted through this artery to reach the heart and look for blockage. However, it is an old method and has its drawbacks including longer recovery time with the need to lie with leg immobilized and strapped for few hours

What is Radial Artery Intervention?

According to Dr. Gaurav Minocha, Principal Consultant, Max Super Speciality Hospital, Vaishali says, Today angiography and interventions on heart arteries like stenting can be done by accessing radial artery. The radial artery supplies the hand with the blood and is the same artery through which the pulse is felt. Performing angiography through radial artery offers numerous benefits including quick recovery and less bleeding.

The radial artery is present in the wrist and is used as an entry point for the catheter. Cardiologist in Delhi at Max Healthcare performs radial artery intervention by threading a thin catheter through the body’s network of arteries. It is inserted into the radial artery which eventually reaches the heart. This procedure is also known as transradial access or the transradial approach.

The rationale behind Radial Artery Intervention

Reaching the heart through radial artery as opposed to femoral artery has its benefits. The hand has dual arterial supply from radial and ulnar arteries. Together, they form deep and superficial palmar arches. It means the radial artery is not an end artery. It is supported by the ulnar artery which gives the required collateral blood supply. Any occlusion when carrying out radial artery intervention does not compromise vascular supply to the hand, making it a less complicated process. Moreover, since the distal radial artery has a superficial course, it is easy to compress the artery using a device. It helps patients mobilise as soon as the arterial sheath is removed after the procedure.

Benefits of Radial Artery over Femoral Artery for heart  Interventions

Typically, angiography is done by inserting a catheter into the femoral artery in the groin. However, radial artery access is getting preferable for its significant benefits, including:

Less Bleeding complications

Radial artery intervention has proved to be helpful in cases where a patient is at high risk of bleeding complications. It is especially beneficial in cases of a ‘hostile’ groin – infections, peripheral arterial disease or morbid obesity. Since the radial artery is superficially located and is much smaller in diameter when compared to a femoral artery, haemostasis after transradial procedures is easily obtained. Haemostasis is the first stage of healing any wound. It is the process which causes bleeding to stop and keeps the blood within a damaged blood vessel. Less bleeding also leads to fewer vascular surgery complications and can be done for the majority of percutaneous coronary interventions (PCIs).

Faster Recovery with early mobilisation and discharge

One crucial advantage of radial artery access over the femoral route is the rapid mobilisation of the patient and quicker discharge from the hospital. According to various trials, the hospital stay was significantly shorter in case of transradial diagnostic coronary angiography when compared to the femoral artery route. The development of percutaneous procedures to diagnose and treat coronary artery disease has transformed the lives of many patients. In fact, patients do not have to lie still and can get discharged the same day after a successful radial artery intervention. It is a day case PCI that offers significant benefits over femoral intervention.

Better Outcomes and survival

In heart attack patients it is urgently required to open the blocked heart artery as soon as possible and best done within 90 minutes or less of arrival to the hospital. Access to the heart matters as such patients are given strong blood thinners before the procedure and access through leg artery can lead to bleeding in the thigh which can be difficult to control.

It has been proven in trials that radial artery access in such patients leads to less bleeding and better survival hence it has been recommended as the route of choice by American heart association and other leading heart associations

Radial artery access thus has the potential advantages of reduced access site complications, rapid patient mobilisation, day care procedures, reduced costs and better survival.

It, however, requires special training to master the technique and be comfortable with it.We at Max Healthcare, have an experienced team of cardiologists that do radial artery interventions regularly with good success.Radial artery intervention when done by an experienced team of cardiologists in the best heart hospital in India can be an excellent alternative to standard angiography with better outcomes.

 

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