When it comes to patient safety and comfort, innovation is not only radial - it's radical
At the Finley Hospital Cardiac Catheterization Lab a new procedure is quietly changing the way surgeons treat the cardiac patients. For heart-catheterization procedures in the United States, cardiologists traditionally access the heart at the groin. While highly successful, this approach has drawbacks: it leaves the patient relatively immobile for several hours following the surgery, and it includes a very small but measurable complication risk. Currently, 95 percent of all such procedures are performed the traditional way.
Dr. Tauseef Khan, M.D., founder of the Finley Heart and Vascular Center, is leading an innovative approach. Radial access is a procedure that achieves the same diagnostic results as traditional cardiac catheterizations. Although it requires specialized equipment and training for the surgeon, the most noticeable difference is the patient experience. The surgical process involves the patient's hand being placed in a special arm board. The arm is cleansed at the wrist's radial artery site. After receiving local anesthesia, a tiny micropuncture needle is inserted. Through a process called fluoroscopic guidance - a common imaging technique used by physicians to obtain real-time moving images of the patient's internal structures - the catheter wire is advanced into the heart. The actual procedure is otherwise very similar to a traditional catheterization using the femoral approach.
Khan says, "Typically with a diagnostic procedure performed from the femoral route, patients are in bed at least three to four, maybe five hours. They have some immobility and cannot move around. With the radial-artery technique, patients are able to get off the procedure table and up out of bed sooner. They are able to go back to their room and sit up in a chair. They can use their other hand to eat with. If they need to go to the washroom, they can. Those are clear advantages."
Khan estimates that within the next two to three years, a majority of heart-access procedures will be done using the new method. Following results of Duke Clinical Research Institute's groundbreaking Radial Versus Femoral Access (RIVAL) trials, it has been determined that radial access results in significantly fewer complaints about pain or recovery time, and does not require higher amounts of contrast dye compared to femoral access. In addition, Khan notes a reduction in bleeding-related complications using the new method.
Although the technique has been recognized for about a decade, only recently has the availability of specialized equipment made it possible. The new procedure does not have any higher equipment costs than the traditional way, and as it becomes more widely used, patients are specifically requesting radial access.