Giving Heart Surgery A Hand

Did you know that the big breakthrough in angiograms is the smaller access through the hand? Dr. Rajesh takes us through Radial Access – a novel procedure for safer angiograms.
A big breakthrough in heart care was the development of minimally invasive procedures such as coronary angiograms and angioplasty. Patients with debilitating and life threatening heart disease can now resume full activity through angioplasty and stenting.

The Traditional Approach
So far, for an angiogram, the approach has always been through the femoral artery in the groin (this is a large artery). A catheter is
guided through the artery to the narrowed blood vessel in the heart and the stent is inserted. This approach through the femoral artery has been traditionally used due to technical ease. It has certain disadvantages, however:

• Prolonged bed rest for many hours after the procedure

• Association with back pain, urinary retention and neuropathy

• Frequent complications such as bleeding, haematomas, pseudoaneurysms etc. that may require longer hospital stay and at times, surgery

A Novel Development
These factors led us to develop a novel approach that we now use as routine at MIOT. Instead of the femoral artery, we now enter using the tiny artery in the wrist called the radial artery. The radial artery approach has several advantages:

• Increased patient safety and comfort

• Patients walk in and walk out of the procedure room

• Complications are rare

The safety aspect of radial access angiography has opened a new world of possibilities. Patients who undergo stenting to blocked heart arteries through this approach are able to go home within a few hours. The patients typically walk out of the room with a small plaster over the wrist, have a cup of tea in the waiting room and leave the hospital in two hours!

Unleashing the radial force
As the radial artery is so easily accessible and also compressible, aggressive blood thinning medications can be used safely. This enables stenting of multiple blockages and complex blockages that would otherwise require surgery. Complete 100% blockages, long segments of blockages, can all be treated using the radial approach. The patients also recover much faster, following the radial approach.

We at MIOT Hospitals routinely use the radial approach for our coronary angiograms and stenting. This optimizes patient safety, comfort and recovery. MIOT has indeed unleashed the radial force!

Dr. R. Rajesh Kanna, M.B.B.S.,
FIC (Canada), MRCP (UK), Interventional Cardiologist