Transradial cardiac catheterization is a procedure used to diagnose and treat conditions of the heart. During transradial cardiac catheterization, a long, thin tube called a catheter is inserted into the radial artery at the inside of the wrist; it is then guided up through the arm, into the chest and, finally, to the heart. Once at the heart, the catheter can be used to detect any blockages or abnormalities; take a blood or muscle sample; measure blood pressure and oxygen levels; detect and repair congenital heart defects; repair or replace heart valves; perform angioplasty or balloon valvuloplasty; and correct arrhythmia.
To be a candidate for transradial cardiac catheterization, a person must have a good blood supply to the hands, not only to the radial artery but to the ulnar artery (at the wrist, the ulnar runs parallel to the radial). If not, and the radial artery becomes blocked, the ulnar artery cannot take over and supply blood to the hand.
Advantages Of Transradial Cardiac Catheterization
The femoral artery in the groin is the typical access point for cardiac catheterization, although transradial catheterization is used with increasing frequency, in large part because it is considered safer. Entering the radial artery through the wrist typically means that there is less bleeding at the incision site, which helps to reduce pain and the risk of infection. And when the catheter is introduced through the groin, it generally takes hours of compression to prevent bleeding. After a transradial catheterization procedure, however, the wrist needs only a small compression device.
Another considerable advantage of transradial cardiac catheterization is the quick recovery it offers. A patient is often not restricted from getting up and walking around following the catheterization. When an artery in the groin is used for access, however, the patient must lie still for several hours post-procedure to initiate healing. Using transradial catheterization also means a faster release from the hospital; depending on the type and extent of the procedure performed, a patient may be discharged on the same day as the surgery.
Transradial Cardiac Catheterization Procedure
Transradial cardiac catheterization is usually performed in a hospital, with the patient being given IV sedation. A local anesthetic is applied to the wrist to numb the area before a small incision is made. A sheath, which is tapered surgical tubing, is placed in the incision. The surgeon then threads flexible wiring into the sheath and through the vascular network to reach the heart. The wire is used as a guide for optimal placement of the catheter, which is then run along the wire through the arteries to the heart.
The catheter is often used to circulate dye so that imaging devices produce clear pictures of the heart and nearby blood vessels. It also provides an effective way of obtaining samples of blood or tissue from the heart, and performing surgery to repair certain problems.
Once the procedure is complete, the catheter is withdrawn and removed through the incision in the wrist. The incision is closed, covered with a bandage, and kept compressed to minimize bleeding. The patient is encouraged to sit up in a chair and, depending upon the type of procedure that was performed, may be permitted to move about, or eat and drink.
When catheterization is performed for diagnostic purposes, a patient is typically released after a few hours of being monitored. For a patient receiving treatment during catheterization, a hospital stay of one or more nights is generally required.
Risks Of Transradial Cardiac Catheterization
Complications from transradial cardiac catheterization occur infrequently, and are usually avoidable. In some instances, transradial cardiac catheterization causes infection and pain at the incision site, or blood-vessel damage. A patient may experience slight bruising or soreness at the incision site, but they usually resolve within a week.