Medically Reviewed by Fred M. Krainin, MD

American cardiologists are turning to an alternate technique to diagnose heart artery blockages that has a number of benefits for the patient. McLeod Cardiologist Fred Krainin, MD, explains sending a catheter through the wrist, rather than through the leg.

Here are notes from Dr. Krainin’s comments:

Here’s a very brief history lesson. A Dr. Werner Forssmann in Germany did the first heart catheterization in 1929. He was a urology resident and thought he should be able to put a tube in the heart. He performed the procedure on himself. He threaded a catheter through his left arm, walked up five flights of stairs to the radiology suite, did a fluoroscopy and proved that the tube went from his arm into his heart. So, the cardiac catheterization was originally done from the arm.

But over the last several decades – particularly in the United States – we’ve done it from the groin and leg, through the femoral artery. For about 20 years, European cardiologists have used the wrist’s radial artery. In the last five years or so, it’s starting to catch on in this country. More cardiologists are now doing transradial catheterizations.

There are 3 major benefits to doing the transradial catheterization, compared to the femoral catheterization.

The most important benefit is patient safety. The major risk of complications from heart catheterizations involved local complications form damage to the artery in the leg where you insert the catheter. Those can be bleeding, blood clot, infection, damage to the artery that might require surgical repair, and bleeding inside the patient’s abdomen. They can be life threatening – although it’s rarely that serious. Transradial catheterization eliminates virtually all those complications. So, it’s much safer than the femoral approach.

The second benefit is patient comfort. Patients tolerate this much better than the femoral approach. There’s less discomfort. Less pain. After a traditional heart catheterization that’s done from the groin, the patient will be required to have several hours of bed rest, flat on their back. After Transradial procedure, the patient can literally get up off the table and walk out of the room. We don’t often do that, because the patient has received some sedation and is a bit drowsy. We don’t want them to fall. But there is no requirement for bed rest. Many times they can recover in a lounge in a comfortable reclining char, rather than lying flat in bed.

In the femoral catheterization, you have to hold pressure on the leg to prevent bleeding after you remove the tube. Or you have to use a suture to close the artery and you’re introducing foreign material into the patient’s body, which can have its own set of complications. With a transradial catheterization you simply remove the catheter apply what looks like a wrist watch that uses Velcro to apply direct pressure to the radial artery. After an hour or two, you can remove that wristband and go home.

The third advantage is cost. Doing a radial catheterization saves money compared to the femoral catheterization.

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