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The Transradial Approach to Cardiac Catheterization

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Angioplasty Procedure

The Transradial Approach to Cardiac Catheterization : Angioplasty is a procedure to restore blood flow through the artery. You have angioplasty in a hospital. The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end.

Angioplasty is one of the most successful treatment procedures for removing blockage in arteries. The angioplasty procedure is considered minimally-invasive and is usually completed within a few hours. It is performed by a medical practitioner specializing in interventional cardiology.

Who Needs Angioplasty?

Angioplasty is a procedure recommended to those who have heart conditions like atherosclerosis. High levels of cholesterol (specifically low-density lipoproteins – the “bad” cholesterol) and fat in the bloodstream can sometimes cause them to build-up and harden to form plaque in the arterial walls. This can cause the arteries to be rigid and less flexible, a condition medically known as atherosclerosis. Atherosclerosis can restrict blood flow causing angina (chest pains) and when untreated, a clot may form which lead to a heart attack.

A candidate for angioplasty will have to go through a series of tests including X-ray, urinalysis, blood tests and electrocardiogram. Not all patients with coronary angiogram can have angioplasty – there are many factors which can render the procedure unsuitable, such as if the blockage occurs in naturally narrow sections or if too many blocked vessels branch off the artery. In cases like these, more invasive alternative techniques such as coronary artery bypass procedure will be suggested.

What Angioplasty Entails

The angioplasty procedure is aimed at opening up blocked arteries to allow smoother and more normal blood flow. It opens up a narrowed artery by inserting a tube (called the catheter) at the narrowed point. A balloon is fixed at the end of the tube, which is then inflated, to push apart the arterial walls outward. This action results to the temporary widening of the narrowed artery and can also break down and crush the plaque build-up. The balloon is then removed and to keep the site open, a coronary stent is placed and remains there permanently to hold the artery open and restore blood flow.

Depending on the severity and the number of blockages, the entire procedure can last about two hours. Patients are usually given sedative to help them relax. Fluids and medications are usually given through an intravenous injection, and local anaesthetic is given. An X-ray photograph is used all throughout the procedure to allow the cardiologist to view and guide the movement of the catheter.

Preparation and Post-Procedure Care

Patients will be instructed not to eat or drink for at least four hours (or more) before the procedure. You will also be given aspirin (anti-platelet) and anti-coagulant medications a few days before. You will be awake the entire time.

After the angioplasty procedure is finished, you should expect to lay flat for at least six hours. You will also be advised to take platelet-blocking medications to prevent blood clotting near the implanted stent. For the next few days, you will be strictly advised to take it easy, and gradually ease back to your regular activities.

A future angioplasty might be avoided by taking better care of yourself, by eating right and getting some exercise. Eat less meat and instead eat more fruits and vegetables. Go for walks, ride a bike, play golf, get in a regular exercise routine.

And don’t forget about the many proven heart health benefits of taking a daily fish oil capsule. Talk to your doctor and he or she will no doubt agree that these three things can be great for your heart health: Proper diet, Exercise & Fish oil.

The Transradial Approach to Cardiac Catheterization : Interventional cardiologist Dr. John Wang, chief of the Cardiac Catheterization Lab at MedStar Union Memorial Hospital in Baltimore, Maryland, walks through an actual transradial cardiac catheterization procedure. For many patients, cardiac catheterization can be performed through the radial artery in the wrist, instead of using an artery in the groin. Traditionally, the femoral artery in the groin is used to access the heart because it is a larger artery that allows for a larger, more easily maneuvered catheter. But after a quick, non-invasive test in the catheterization lab to be sure that there is sufficient collateral blood flow to the hand, Dr. Wang easily makes access using the same coronary arteries through the wrist as during a femoral catheterization procedure. If the patient’s condition indicates a need for a stent, this can be done through the wrist as well. The procedure is more comfortable for patients and allows them to sit up and move around soon after. To learn more:

To learn more about Dr. Wang, or to request an appointment, call 877-74-HEART (877-744-3278).

For media interviews with Dr. Wang, please call Debra Schindler, regional director of media and public relations, MedStar Health Baltimore at 410-274-1260.

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