Doctors at the Ohio State University Medical Center are trying something new for heart patients. Not only are they using patients’ wrists to access blocked arteries near the heart, but they are also sending patients home the same day.

Dr. Quinn Capers IV, interventional cardiologist and director of Peripheral Vascular Interventions at OSU Medical Center, estimates that only 10 to 20 hospitals nationwide send patients home the same day as the procedure.

This medical procedure is performed when the blood vessels near the heart become blocked and the flow of blood is restricted or stopped to some areas of the heart.

 

Doctors can use an artery in the wrist to thread a small balloon to the blocked blood vessel. The balloon is then inflated to re-open the vessel. Often, doctors implement a small piece of wire mesh tubing, called a stent, to keep the vessel propped open. The procedure restores blood flow to the heart.

In the U.S., only 1.3 percent of all stent procedures are performed through the wrist. Most stent procedures use a large blood vessel in the patient’s inner thigh, according to a report in the August 2008 Journal of the American College of Cardiology: Cardiology Interventions.

If the stent procedure is done using the inner thigh, the patient must remain in bed rest for several hours after the procedure to reduce the risk of bleeding. Most of those patients stay overnight at the hospital, Capers said.

Patients who undergo the stent procedure through the wrist, however, can sit up and walk around immediately after the procedure. There is also less risk of bleeding and other complications. And now some patients can go home a few hours after the procedure, he said.

“Patients love the … stent procedure through the wrist and many now ask for it,” Capers said.

For the doctor, using the radial artery in the wrist rather than the femoral artery in the thigh is a technically difficult procedure.

“The skill level needed to perform the procedure is the only real challenge, and it can be overcome with experience,” he said.

Dr. Steven J. Yakubov, interventional cardiologist with MidOhio Cardiology and Vascular Consultants, said about 60 percent of the stent procedures he performs at Riverside Methodist Hospital are through the wrist.

Most of the doctors in Yakubov’s practice continue to use the femoral artery in the thigh for the stent procedure. They have experience with that procedure and do not see a reason to learn a new technique, he said.

One of Yakubov’s colleagues continues to do about 90 percent of his procedures through the artery in the thigh. Dr. N. Howard Kander, interventional cardiologist with MidOhio Cardiology and Vascular Consultants, said he has little interest in using the wrist procedure.

He was trained using the femoral technique and is pleased with how well the procedure has worked for the past 20 years, he said.

Dr. Morton J. Kern, an interventional cardiologist and associate chief of cardiology at University of California Irvine Healthcare, performs about 50 percent of heart procedures through the wrist.

Patients who have had a heart procedure through the thigh and then have the procedure done through the wrist find it an improvement, he said.

“Universally, they love it,” Kern said.