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Healthcare Quarterly
New cardiac catherization procedures take radial approach

Traditionally, procedures that require heart catheters for cardio patients have required a long waiting period afterward, which brought both discomfort and potential for bleeding. Physicians in Europe have long been using the radial vein (located in the wrist) — instead of the femoral, or groin vein — which allows patients to get up and walk within short minutes of the procedure. The radial approach also has less likelihood of complications and bleeding.

Physicians in the United States have been adopting the procedure more in the past few years, and some cardiologists are using it now at Harrison Medical Center.

Christopher Johnson, MD, a cardiologist with Kitsap Cardiology Consultants, said the procedure could be used for almost all patients, though currently it’s not used as much in acute cases. “That will change as physicians do (the procedure) more and more,” he said.

Johnson has been using the radial approach occasionally for a few years but last year he decided to focus on it more. “It’s a patient comfort issue and patient risk issue,” he said. “The advantage is that the bleeding complication rate is exceptionally low — bleeding is the Achilles’ hill of the femoral approach.”

The downside of the radial procedures is their success rate. With femoral catherization, the procedural success rate is about 96 percent, vs. 83 for radial; the access failure rate is virtually zero for the groin and about 2 percent for radial. The radial approach also adds as much as four minutes to the catherization procedure, though the more physicians perform these, the faster they become.

Johnson said during one of the meetings where he saw presentations on the radial technique, one patient in Europe was able to get up from the table and walk to the recovery area after a very complicated procedure for both right and left arteries that have been blocked for several weeks. “To think of doing that with a femoral artery would be a mistake,” he said.

The new cardiovascular center at Harrison has allowed for the radial approach to be used more easily thanks to the collection of equipment in the catherization lab. The technique, which could also be used for interventional procedures, could entail some cost-savings because of the reduced patient recovery and staff time, as well as the fact that closure devices frequently used for the groin are not needed.

“Patients are asking for it more and more,” Johnson said. “As time goes on, we apply it to more and more patient groups.”

 
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