From the wrist to the heart: A safer route for angioplasty?

In the United States, at least half of all artery-opening procedures in the heart now start at the wrist instead of the top of the leg.

To open a narrowed or blocked artery in the heart, a doctor’s first step is to carefully maneuver a slender tube (catheter) through a major blood vessel up to the heart. Traditionally, that vessel has been the femoral artery, the large vessel at the top of the thigh. But increasingly, cardiologists are starting at the radial artery in the wrist instead (see illustration).

Called transradial angioplasty, the wrist approach offers several advantages for patients, says Dr. Ajar Kochar, an interventional cardiologist at Harvard-affiliated Brigham and Women’s Hospital. "They can sit up right away, which means it’s easier to get up, walk around, and eat soon after the procedure," he says. To cover the tiny incision just under the base of the thumb, all they need is a pressure bracelet around the wrist.