Geisinger expert: Inserting cardiac catheters through the wrist improves safety, patient comfort

DANVILLE – Geisinger cardiologists are inserting plaque-busting cardiac catheters into a patient’s wrist in a procedure that reduces the bleeding risk and makes the patient more comfortable.

During an angioplasty, a catheter is threaded through a patient’s artery until it reaches a blockage. The catheter is inflated, which pushes fatty plaque against the artery wall and restores normal blood flow to the patient’s heart.

Most cardiologists deliver balloon tipped catheters into patients via the femoral artery in the groin. However, using the radial artery in the wrist lowers the risk of bleeding and infection and improves patient satisfaction, said Geisinger cardiologist Kimberly A. Skelding, MD.  One of the most worrisome complications is bleeding in the groin, which can be fatal. 

“Many cardiologists do not routinely use the wrist as because they weren’t trained or don’t do it regularly enough to have the necessary skills,” Dr. Skelding said. “By inserting through the wrist, we significantly reduce the likelihood a patient experiences excessive bleeding.”

An angioplasty helps patients with a potentially-fatal condition known as atherosclerosis, where plaque builds up in an artery and causes a blockage. Many patients who have cholesterol and plaque in their arteries to their heart also have them elsewhere. Inserting through the wrist may mean the difference between life and death if arteries in the patient’s legs are blocked. 
 
A recent study in a recent Journal of the American College of Cardiology found that bleeding complications in angioplasties done through the femoral artery in the groin were twice as common compared to the wrist approach. The study also noted that just 1.5% percent of all catheterizations are initiated through the wrist.

Dr. Skelding said the approach is becoming more widely practiced by clinicians as patients are asking for it and research shows that it’s safer. “There is a learning curve for cardiologists,” said Dr. Skelding, who has published numerous articles on heart disease. “It’s important that this procedure is performed by a clinician with experience to get the most benefit.”

Benefits extend beyond a reduced risk for bleeding complications. “Patients prfer this because they can sit up right after the procedure,” Dr. Skelding said. “This means the world to patients with bad backs, those that are full-figured and patients with breathing problems.”

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