Health Team

Study: Is wrist or leg artery better to reach heart?

Posted May 9, 2011

— The shortest path to the heart turns out to be the best one – not in love necessarily, but in cardiac catheterization, one of the most common procedures in the U.S.

Researchers compared two routes to the heart, through a major artery in the leg or by way of the wrist.

Glen Leif, 61, had two cardiac catheterizations within four years to check for blocked heart arteries. The first was performed through the femoral artery near the groin. The second, just over a year ago, was done by Duke cardiologist Dr. Sunil Rao through the radial artery in the wrist.

“It's much more common outside the U.S.,” Rao said. “The latest estimates for the U.S. put it somewhere between 8 and 10 percent of physicians using this approach.”

Rao helped lead a study of 7,000 patients who had suffered heart attacks in the U.S., comparing the two approaches.

They looked for complications, such as another heart attack, stroke, bleeding or death 30 days after the procedure. Both had similar results, but the radial approach was slightly better.

“Those patients not only had a lower rate of complications, but they actually had better survival from their heart attack,” Rao said.

Fewer of the sickest patients died within 30 days. Most patients, such as Leif, who've had both procedures prefer the radial approach.

“The femoral artery, you have to lay flat for four hours after the procedure. That was a little uncomfortable,” Leif said.

It takes longer for the deeper wound in the femoral artery to stop bleeding.

“Now, the recovery after the wrist procedure was a lot different. I was sitting up. I was talking to my wife,” he said.

After the first procedure, Leif needed four days away from work. As for the wrist, “I could have worked the next day,” he said.

Emergency heart patients are more likely to get the catheterization procedure through the femoral artery in the leg, but patients who can schedule a catheterization can request the radial approach.

Patients can also ask about different physicians' experience in using the wrist artery for the procedure.


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  • KB2IYS May 13, 2011

    Had a heart cath through the femoral artery at WakeMed back in 2004. Next day, a second procedure this time through the radial artery. Both were painless, neither gave me problems. I do remember having to lie there for "awhile" after the first cath; no such expenditure of time after the second.

  • Tax Man May 11, 2011

    I had this done through my right wrist - the next day I drove home from the hospital! Healed quickly and very fast recovery. Been over a year now and I feel great. Of course it was these Duke Cardiac Surgeons and their staff who did such a great job! Thanks Duke!

  • Avenger May 11, 2011

    I had it done in the Groin in 1997. I lay there for at least 4 hours. The wrist seems like the best way to go. It is good to have that option.

  • Wags May 10, 2011

    I had it done in the groin a few years ago. I don't remember having to lie flat for 4 hours...maybe and hour or so. I was back to work pretty quick. Going through the wrist probably makes more sense. I really enjoyed the heat rush from the dye.

  • Scubagirl May 10, 2011

    It's certainly much easier to care for a radial approach than a femoral one, that's for sure! Great advancement by cardiologists! I remember when it was rare to use that approach, and only if the femoral access wasn't available/best/blocked.

  • gajo May 10, 2011

    I had this done In January 1999 at Durham Regional.. they had me all prep and whenI arrived to do the catherization they put it in the wrist I was really amazed how much better it can be.not having to lie flat for hours and just a bandaid..was all