Every year in this country, a million and a quarter people undergo a cardiac angiogram, a test to look for blockage in heart arteries. The long standard way to do this works well, but has a big disadvantage for patient comfort.
Even though he's been feeling fine, 70-year-old Stan Perlman recently had an abnormal stress test, which could reflect a problem with his heart. Doctors felt there was minor blockage in one of his minor arteries, but there was no way to know. To find out for sure, his doctor ordered an Angiogram, a test used to diagnose blockages, where doctors insert a catheter into the heart to outline heart arteries.
Traditionally, the catheter is inserted into the leg artery, in the groin. Only problem is what the patient has to do after the procedure to keep the artery from major bleeding. "It was more than uncomfortable. I mean, uncomfortable is a minor phrase. When you have to stay immobile for 5 hours it becomes a major episode," says Stan. To avoid all that, the doctor is going in through stan's wrist.
Dr. Kirk Garratt says, "The wrist approach is technically just a little bit more challenging. So it can take a little extra effort on the part of the operator." The images of the heart arteries are exactly the same, the big advantage is patients recover faster and they're more comfortable. "Some of the advantages of using the wrist artery include it being a safer procedure. And we have a lot of studies now that confirm tha," says Dr. Garratt.
Not everyone can have an angiogram done this way. People with small arteries in their wrists or those with unusual differences in their hands aren't candidates. But for most, it will get them out of the hospital faster. Less than five percent of angiograms are done through the wrist because most training is done for the leg insertion. Nationwide, only about five percent, that's one in 20 angiograms, are done through the wrist. Even accounting for patients who aren't the right candidates, many more could be done. Dr. Garratt says its because doctors are trained in the tried and true groin artery approach and don't always want to learn a different technique.