New Approach to Unclogging Coronary Arteries

The traditional approach to angioplasty, a medical procedure in which cardiologists clear blockages in coronary arteries, involves inserting a catheter into the patient’s femoral artery, a very large blood vessel buried at the groin deep in a patient’s leg.

Now cardiologists at AAMC have another route to restore blood flow to the heart muscle—through the wrist. It’s called radial artery angioplasty and is especially beneficial to patients like Jim Smith, 68, of Centreville, MD.

He was rushed to the hospital by ambulance after suffering a heart attack. Doctors on the Eastern Shore had sent him across the Bay Bridge to AAMC where nurses, technicians and cardiologists were waiting for him in the Cardiac Catheterization Lab. The Cath Lab team is on call 24 hours a day, 365 days a year to save the lives of heart attack patients.

For Jim who had already had a deep vein thrombosis removed from his leg, catheterization through the femoral artery posed a slightly higher risk of complications. Fortunately, interventional cardiologist Scott Katzen, MD, was able to offer a newer, safer route to Jim’s heart—catheterization at the wrist, the radial artery.

“The radial artery approach has a lower risk of bleeding complications,” said Dr. Katzen who has performed hundreds of radial artery catheterizations. “It’s more comfortable for the patients, and they literally can be in bed sitting up eating their lunch a half hour after the procedure.” After a femoral artery catheterization, patients must lay flat for several hours.

By inserting the catheter, a long and narrow tube, into the radial artery and threading it up to a patient’s heart, Dr. Katzen cleared the blockage. The catheter has a tiny balloon inside which is deployed to open the clot. In some cases, cardiologists also may insert and leave a stent to keep an artery open. A stent is a small narrow metal mesh tube-like device.

Since September 2012, Dr. Katzen has been performing radial artery catheterizations regularly at AAMC, and patients like Jim have been impressed with how easy it was to go through. “It was amazing. There was no pain involved at all,” said Jim. “It was just like having blood drawn except that instead of drawing blood they put a catheter in there.” The day after his heart attack, Jim was back at home. “The procedure was just so smooth and easy,” he said, “There were no after effects or any recovery time, it was really great.”