Heart Surgery Through the Wrist?

Traditionally a procedure to clear the main artery on the front part of the heart would be performed through the leg/groin area. Recent medical breakthroughs, technology and skilled interventional cardiologists have been able to improve the process through radial (wrist) access. This reduces recovery time, is much more minimally invasive and involves a much shorter procedure time. Currently Carson Tahoe Health is the only hospital in Northern Nevada to provide this revolutionary procedure.

Below is a video of Doctor Tann and his patient Hector to demonstrate the procedure, followed up by a Q&A session with Doctor Stephen Tann.

Exclusive at Carson Tahoe, specially trained interventional cardiologists perform an advanced procedure in the treatment of Coronary Artery Disease.  Recognized worldwide, the Radial Technique accesses the radial artery through the right wrist for stent placement resulting in improved patient safety and satisfaction.

What is Coronary Artery Disease?
Coronary Artery Disease (CAD) is a condition in which plaques build up on the walls of the coronary arteries – the vessels that supply blood to the heart muscle. These plaques can cause a gradual but progressive narrowing of the artery, or they can suddenly rupture, causing a more acute obstruction.

What is the Radial Technique?
Typically, for stent placement, the femoral artery in the groin, is the standard access site.  Using the radial approach an Interventional Cardiologist uses the small artery in the wrist as an access site, improving patient safety and comfort.

Why does is improve patient safety and satisfaction?
With cardiac catheterization and interventions, regardless of the cause or the source, bleeding leads to worse patient outcomes. Bleeding has been shown to be one of the most potent risk factors for adverse outcomes (e.g. death, recurrent heart attacks, etc), regardless of the technical success of the procedure itself. As such, there has been an intense focus in the last decade or so on reducing bleeding complications.

The radial artery is not only a much smaller vessel than the femoral artery (the standard site of access for cardiac catheterization), but it is in a place where it can be very easily compressed if bleeding does occur. If there is a problem with bleeding at this site, even minimal manual pressure over the artery can quite easily control the problem. Many studies have now shown that bleeding rates with the radial approach, when compared to the standard femoral approach, are much lower, leading to improved short and long term outcomes.

Another benefit of the Radial Technique is improved patient comfort. After a femoral catheterization, patients need to lie flat on their back for 3-4 hours after the procedure.  With the radial approach, patients can be up and out of bed in an hour after their procedure.

Am I a candidate for the Radial Approach?
Unless there’s a poor radial pulse, all patients are candidates.

If it improves patient safety and comfort, why aren’t all stent placements done using the Radial Approach?
Presently in the US, less than 10% of all catheterizations are done via the radial technique. This is primarily a function of currently practicing cardiologists’ lack of training in the technique.

For most of today’s practicing Interventionalists, adopting the radial technique means learning a new technique. There is a learning curve to the radial approach to cardiac catheterization, and most experts will say that it takes 50-100 cases to become proficient with the technique. To a busy practicing cardiologist, who is very used to and very comfortable with today’s standard femoral (groin) technique, this is not an easy sell. However, the ‘radialist movement’ is gaining traction in the US, and its numbers are increasing as training programs are now recognizing its value, and doing a better job teaching the technique to current cardiology fellows.

Where are stent placements done?
Carson Tahoe Cardiologists perform this procedure in one of the three state-of-the-art catheterization labs located inside the Carson Tahoe Regional Medical Center. For more information about the Radial Technique, the catheterization lab or Coronary Artery Disease, call Carson Tahoe Cardiology at (775) 445-7650

Dr. Stephen Tann is an Interventional Cardiologist at Carson Tahoe Cardiology.