Safer Passage | by Kris Scott

transradial cardiac catheterization, Sky Ridge

Posted on Mon, Aug 8, 2016

Modern Coronary Procedure at Sky Ridge Lets People Get Back to Their Lives Faster Than Ever

The day in late March started like most for Craig Martin. With his kids at school and his wife off to work, the 48-year-old Parker resident jumped on his elliptical for a workout. When Martin’s family moved to Colorado from Los Angeles in 2012, they did so in part because of their passion for the outdoors and commitment to a healthier lifestyle. Martin, a remote programmer analyst who spent a good chunk of his day staring at a computer screen, was committed to staying in shape in preparation for a multi-day backpacking trip in April.

transradial cardiac catheterization, Sky RidgeAs he stepped into the shower following his workout, however, his day turned anything but routine. He began experiencing shoulder and neck discomfort, which rapidly progressed to chest pains and shortness of breath. He called his wife, who told him to “call 911.”

Dr. Benjamin Yang, Sky Ridge Medical CenterIt did get worse. “Rather quickly,” he says, adding, “there wasn’t a lot of ambiguity there.” So Martin, who’d read that the “No. 1 factor for survivability” during a heart attack was getting quick medical attention, called the paramedics. After treating him at home with aspirin and nitroglycerin and performing an EKG, they rushed him to Sky Ridge Medical Center. There, Dr. Benjamin Yang, an interventional cardiologist, would perform a procedure that would have Martin home in two days and back to his regular activity level in less than a month.

Yang performed a heart catheterization, which revealed an 80-90 percent blocked heart, or coronary, artery. He used a straw like tube, or catheter, entering through Martin’s wrist and traveling up his right arm to his chest. Yang then inserted a wire in the same passage to “snake through” the blockage, and then used that wire as a rail to insert a balloon, opening the problem area. Once the balloon was placed, Yang stented the area. Stents act as metal scaffolds that “prop the artery open and push the blockage to the side,” he says. Modern stents, such as the one Yang used, are also coated in drugs that help further prevent a re-blockage from occurring throughout a patient’s lifetime. “Within three years,” he says, “95 percent of patients have no problems with re-blockage within stented areas.”

Dr. Benjamin Yang, Sky Ridge Medical CenterTraditionally, this procedure has been done by going in through a patient’s groin, where the femoral artery, which is about the width of a thumb, is located. The wrist artery, also known as the radial artery, is two to four millimeters — close to the thickness of a strand of spaghetti,” Yang says. Because of this difference, the femoral route carries a greater risk of serious bleeding complications. The radial artery option, however, is not without risk. It involves more twists and turns, meaning doctors like Yang have to navigate more carefully. “Sometimes, you have to be flexible and creative in terms of getting there,” Yang says. While there can be risks, they are slight when performed by a doctor like Yang, who’s performed wrist catheterizations countless times and was trained
specifically in this technique.

Dr. Benjamin Yang, Sky Ridge Medical CenterThe benefits of the radial route, and the fact that more cardiologists-in-training, or fellows, are trained to perform the procedure, make it increasingly more common. In addition to a decreased risk of bleeding complications, the benefits include reduced recovery time and more comfort after the procedure. Patients who have the catheterization through the groin have to lie flat, not bending the affected leg, for an average of three to six hours while the groin heels. Heart catheterization via the radial artery allows patients to sit up immediately after surgery, and patients can sometimes return home the same day or night. “The entire thing,” Martin says, “took about 45 minutes, and I was conscious during the procedure.”

Because he has a family history of cardiac problems, Martin wasn’t all that surprised by his heart attack. What he was surprised by, he says, is how quickly he was back home and going on with life. He went car camping a week after the procedure and, a month later, backpacked for four days in Canyonlands National Park. He attributes that in part to Dr. Yang — “I feel very fortunate that I found a doctor at Sky Ridge who was up on the latest technology and medical procedures,” he says.

But Martin did something right, too: He called 911. Though he says that he “pretty much knew” it was a heart attack, he knows others would hesitate to call for paramedics. “I know there’s a feeling you get of, ‘Oh, I don’t want to go to the hospital. It’ll be expensive, and I don’t really know if it’s serious enough for a 911 response.’ But I called, and I’m glad I did.”

Yang echoes that sentiment, and offers up some further advice. “There is such a wide spectrum of reasons that people can have chest pain,” he says. “The rule of thumb that I tell people is, if the pain isn’t going away after five to 10 minutes — if it’s a persistent pain, particularly pain or discomfort brought on by physical exertion — that’s definitely an alarming symptom. You have to pull the rip chord on what’s going on and call 911. This really is a case of being more safe than dangerous or sorry.”

What is transradial cardiac catheterization?

The transradial approach is performed through radial artery access, it means your doctor will use the radial artery in the wrist as the entry point for the catheter. The cardiologist threads the thin catheter through the body’s network of arteries in the arm and into the chest, eventually reaching the heart.

Advantages of cardiac catheterization performed through the wrist

Transradial cardiac catheterization (wrist) offers a less invasive, lower-risk option compared to traditional femoral artery (leg) access for cardiac catheterization because the procedure is performed through a small artery in the wrist rather than the groin.

Dr. Benjamin Yang, Sky Ridge Medical CenterThe radial artery approach (wrist) is safer for patients as it is associated with less bleeding and fewer complications compared to the femoral approach (leg).

  • Minimal bleeding
  • Less risk of nerve injury
  • Lower rate of complications
  • Faster recovery
  • More comfortable for patients as they can move around
    immediately after the procedure, instead of staying in the bed for several hours
  • Potential discharge to home the same day even after stenting procedures

When would you potentially need a cardiac catheterization?

If you have symptoms of heart disease but are medically stable, your doctor may suggest cardiac catheterization as an elective procedure to check for blockages in the coronary arteries and to evaluate how well the heart’s main pumping chamber is working.

Cardiac catheterizations also may be performed emergently in patients suspected of having a type of heart attack known as an ST elevation myocardial infarction (STEMI), in which there is a complete and prolonged period of blocked blood supply affecting a large area of the heart. Cardiac catheterization can be used not only to locate the blockage, but also to treat it. Source:

Did you know?

In a recent issue published in the journal Heart researchers compared transradial (wrist) versus transfemoral (leg) access by analyzing data from nine previous studies involving nearly 3,000 STEMI patients undergoing cardiac catheterization. What they found was that transradial access during coronary intervention (PCI) cut mortality by 47 percent, and major bleeding complications were reduced by 37 percent and access site complications by 70 percent.


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