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It's All in the Wrist

Transradial Catheterization Offers Several Benefits for Patients

Sandeep Nathan, MD, MSc Interventional cardiologist Sandeep Nathan, MD, MSc, is an expert in transradial angiography, a cardiac catheterization technique that reduces the risk of bleeding and improves post-procedure recovery, when compared to traditional femoral artery catheterization.

For University of Chicago Medicine interventional cardiologist Sandeep Nathan, MD, MSc, it’s all in the wrist.

Nathan, director of interventional cardiology research and education, is an expert in transradial catheterization, a technique not widely available even though it offers many advantages for patients.

In the traditional approach to angiography and other procedures to diagnose and treat heart problems, the catheter is threaded through an artery in the groin. Transradial angiography uses an artery in the wrist instead.

Most people are good candidates for the radial approach, Nathan said.

Patients typically are able to get up and walk immediately after the procedure, and the risk of complications is lower, Nathan said. When the catheter is inserted through the groin artery, the patient must rest in bed for several hours following the procedure.

Nathan has performed approximately 1,000 transradial catheterizations. He teaches the demanding technique to physicians around the country and at an annual summit held at the University of Chicago.

Training other physicians “is a golden opportunity to improve patient comfort, safety, and efficacy,” he said.

Bleeding is the biggest risk with the traditional approach using the femoral artery deep in the groin. Studies show that approximately 10 percent of angioplasty procedures trigger minor bleeds, and 5 percent become major bleeds. The wrist artery is so close to the skin’s surface that bleeding can be recognized and controlled quickly.

Most people are good candidates for the radial approach, Nathan said. Still, he estimates that 90 percent of U.S. patients get femoral catheterizations.

“We’re working hard to educate and train other physicians,” he said. “And patients should self-advocate. There’s so much to gain, and nothing to lose, by talking to your doctor about this.”

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