Cardiologists are increasingly turning towards the trans-radial approach, which entails reaching the heart through the radial artery in the wrist. This method is relatively safer and more cost effective than the traditional method of approaching the heart through the femoral artery in the groin, says India’s leading Cardiologist Dr. Tapan Ghose, Director & HOD Interventional Cardiology at Paras Hospitals, Gurgaon.
When Dutch Cardiologist Dr. Ferdinand Kiemeneij first conducted a minimally invasive heart intervention through the wrist in 1992, it was believed that the approach would be needed only in some patients - on whom the traditional groin approach was not feasible. The procedure was initially thought to be useful for patients with weaker lower limbs. However, over the past few years this method is increasingly finding favour with Cardiologists, for being safer and more convenient. Minimally invasive techniques, as these are called, also reduce the recovery time and the risk of something going wrong. Wrist Angioplasty is among the latest improvements in the field - Angioplasty is a minimally invasive technique that is used to diagnose and unclog blocked or narrowed arteries. Catheters or stents are inserted through arteries into the body, to open up the obstructed artery and resume the blood flow.
Dr. Tapan Ghose, Director & HOD Interventional Cardiology at Paras Hospitals, Gurgaon, advocates this approach, and says, “Wrist Angioplasty definitely saves more lives as it reduces the chances of complications in patients, reduces bleeding and lessens the recovery time. For patients it is much more comfortable. Many doctors are today realizing this.” Dr. Ghose is among the pioneers of this trans-radial approach in India. Recently, researchers at the University of Pennsylvania, the University of Washington Medical Center and the University of Pittsburgh School of Medicine conducted a cost-benefit analysis, and concluded that the trans-radial artery approach resulted in less vascular complications and significant cost-savings (as against the femoral artery catheter access). In acute heart attacks, Wrist Angioplasty saves more lives as compared to the groin route. While doctors in the US, Canada, EU and even Japan have taken to wrist Angioplasty, it is still not very common in India – it is done in about 30% of the cases. “There are lesser number of Interventional Cardiologists trained in the trans-radial approach. The majority of the training institutes do not have a structured training programme for this approach of Angioplasty,” points out Dr. Tapan Ghose.
Cardiologists have traditionally preferred the femoral approach because the artery in the groin is a larger blood vessel (as compared to the artery in the wrist). This makes it easier to insert catheters. “This was true till some years ago but, with smaller and more flexible catheters being developed now, this difficulty has been resolved. That makes it equally easy to insert catheters through the wrist,” says Dr Ghose. “We have certainly come a long way from the days of Open Heart Surgery,” says Dr. Ghose.
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