Wrist routed heart procedures best alternative to uneasy groin route ones, Dr Jaswal
Prefer wrist way to angioplasty for comfort, better results, says Dr Jaswal
5 Dariya News
Mandi 20-Sep-2014
The radial (wrist) angioplasty is best alternate to uneasy groin angioplasty, which yields better results and provides greater comfort level, said Dr R K Jaswal, Director Cardiology, Fortis Hospital Mohali.While talking about the latest updates in heart treatments and surgeries with the media persons ahead of World Heart Day (September 29), Dr Jaswal said radial artery angioplasty helps perform surgery from wrist to the heart. “The radial artery supplies blood to hand. It’s the artery you press when you take your pulse. This artery offers ready access to the heart and is sometimes easier to get at. Doing angioplasty through it tends to cause less bleeding around the puncture after the procedure is over than the groin approach,” said Dr Jaswal. The Fortis cardiac surgeon had delivered a lecture in Beijing, China in 2010 at World Congress on ways to handle difficult angiographies and angioplasties through the wrist artery.
Having one of the largest experiences in north India, he has conducted more than 14,000 transradial invasive procedures and over 7,000 transradial interventions including complex transradial coronary interventions.Quoting an international study called RIVAL that compared the two approaches (radial and groin) he said it was found that both ways were equally successful up to 95 percent at opening the troubled heart artery.“Rates of death, heart attack, and stroke within 30 days of the procedure were identical. But there were fewer cases of bleeding around angioplasty entry site with radial approach, and it also appeared to be more effective than the groin approach for treating people in the midst of a heart attack. The results were presented at the American College of Cardiology meeting in New Orleans and also published in The Lancet,” he said.He laid emphasis on experienced team headed by a competitive surgeon that can put the radial angioplasty to best use. “As the artery in the wrist is smaller than the groin artery, and it has more twists and turns, doctors' dexterity and skill are of utmost importance,” he said.He added that as per another research if one gets angiography or angioplasty done via artery, he or she has lesser risk to life following the procedure, than when one gets it done through conventional approach of thigh artery, as practised by a majority of cardiologists in India.
The biggest advantage of radial procedures is that the patient need not lie still for several hours after the procedure to make sure bleeding has stopped. “In fact, people who have wrist angioplasty can often go home the same day. It is kind of day care or walk in – walk out procedure,” he said.Added to this the PATIENT can sit up and feed himself after going through the radial procedure. Also the angiography and stenting through wrist artery has none local complication rates, as compared to 2-8 percent risks when following the conventional method through thigh artery.He added that the women especially find it more comfortable going through the angioplasty or angiography via the wrist artery as they don’t have to expose their groin area. Also groin is more vulnerable to infection in the body after angiography or stenting. Wrist, on the other hand, does not carry any such risks.
Highlights:
Advantages of wrist routed procedures over the groin ones:
· Wrist artery offers ready access to the heart and is easier to get at. Angioplasty through it causes less bleeding around the puncture after the procedure is over than the groin approach
· Area around wrist has lesser chances of infection than that around the groin which is vulnerable to high rate of infection
· Patient need not lie down after the procedure and can easily sit and be back home earlier unlike those that undergo groin procedures
· Women especially find the wrist procedure more helpful as they don’t have to expose their groin.