Abeer Basu, a 53-year-old executive in a multinational firm, was scheduled to fly to Lucknow to attend an important meeting. But the evening before his departure, he felt a heavy sensation in his chest. Earlier, he would have ignored it, but the untimely death of his father and uncle — both in their early-40s — due to coronary artery disease had taught him otherwise. Also, the last annual check-up had revealed a high-normal cholesterol reading. So, Basu dropped by at his cardiologist’s.
Since his symptoms suggested a probable coronary artery block and as he was unfit to undergo a Treadmill Test due to chronic asthma, the doctors advised an angiogram the next day. The angiogram showed no blockage in the coronary arteries and within hours, Basu was off to the airport. “I can hardly believe I had a cardiac intervention this morning,” exclaimed Basu, leaving for Lucknow the same evening with just a small bandage on his wrist.
This is medical science, not science-fiction. With the radial artery approach of intervention becoming popular, patients can now walk out of the hospital after just one or two hours, while angioplasty patients need to rest for at least four to six hours.
“Technically, the only difference between the conventional procedure and this one is that here, the catheter is introduced through the blood vessel of the wrist and not that of the groin —the femoral vessel,” says Sunil Lhila.
The interventional cardiologist at Apollo Gleneagles Hospitals has performed a number of radial artery interventions and feels the sheer convenience for the patient is making the method popular.
Over the years, angiogram or angioplasty through the femoral artery has been the convention, but it involves immobilising the patient for six to 12 hours to prevent bleeding from the puncture site and also causes far greater discomfort.
It is here that radial artery scores. Apart from being less painful, the procedure can be completed faster and the bleeding can be controlled by simple compression. As the patient’s mobility is not restricted, he can be released the same day. “Least disruption to normal activities, while providing the maximum benefit to the patient is one of the important parameters to judge the success of a particular treatment and here lies the advantage of radial artery intervention,” says Aftab Khan, consultant interventional cardiologist at the same hospital.
Nearly all procedures like angiograms, angioplasties and stent deployment in all major arteries like the coronary, carotid, and abdominal aorta can be done through the wrist. The radial artery approach has also been found “a better option” for renal artery angiograms and stentings, according to the doctors. “But since the radial artery is smaller than the femoral artery, it requires greater precision on the part of the doctor performing the procedure,” stresses Khan.
“Only a competent interventional cardiologist can decide upon the route to enter the heart after reviewing individual cases and discussing the options with the family,” adds Lhila.
With the availability of smaller-sized catheters and advances in procedural techniques, radial artery intervention has become very safe and shares the same success rate as the femoral vessel procedure, the doctors maintain.