Harvard Heart Letter

Reaching the heart through an artery in the wrist

Artery-opening angioplasty via the arm is a good alternative to the approach that starts at the groin.

All blood vessels lead back to the heart. That's the basic idea behind artery-opening angioplasty. A doctor inserts a thin tube known as a catheter into a major blood vessel, gently maneuvers it through the vessel and into the heart, and uses an inflatable balloon on a wire to open a blocked coronary artery, usually placing a stent. Most doctors in the United States begin angioplasty at the femoral artery, the large vessel at the top of the thigh. But a growing number of doctors here are following what their European and Asian colleagues are doing: beginning angioplasty through the radial artery in the wrist. This approach is less likely to cause bleeding—and has other potential benefits to boot.

Easier recovery

"The major advantage to radial angioplasty is that the recovery is a lot easier," says cardiologist Dr. Pinak B. Shah, assistant professor of medicine at Harvard Medical School. "Immediately after the procedure, people are able to get up and walk around. They can often go home the same day and resume normal activities by the next day," he adds.

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