ISET: For Angioplasty, Wrist Entry May Be Safer Than Groin

Less bleeding, less overall risk, especially in obese patients

26 jan 2009 -- For most patients undergoing angioplasty to treat blocked heart arteries, entry through the wrist is safer and cheaper than entry through the groin, according to research presented at the 21st Annual International Symposium on Endovascular Therapy, held from Jan. 18 to 22 in Miami.

Ramon Quesada, M.D., of the Baptist Cardiac & Vascular Institute in Miami, and colleagues analyzed data from over 5,000 angioplasty procedures, predominantly via the femoral artery as only 2 percent of minimally invasive heart treatments are currently performed via the wrist.

Whereas studies suggest that angioplasty via the femoral artery has a 2.8 percent risk of bleeding or nerve damage, radial approach angioplasty conducted at the Baptist Cardiac & Vascular Institute had a 0.3 percent risk of bleeding complications and none of the patients had nerve damage, the authors note. Although wrist access angioplasty would be suitable for up to 75 percent of patients, those with very small or twisted arteries, and those who are extremely thin would not be suitable candidates, the researchers found.

"Using the radial approach results in lower cost, less time before the patient can get up and walk around and fewer complications," Quesada explained in a statement. "Patients who are ideal candidates for the radial approach are those who are obese or have severe peripheral arterial disease."