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Handling Heart Problems Could Be All In The Wrist

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RALEIGH, N.C. — Usually when cardiologists send catheters to the heart, it's done through the femoral artery in the leg near the groin. There is always the risk of bleeding problems after the procedure, but that's less of a problem when the procedure is done through the wrist.

Willard Morton, 87, is thankful for one thing.

"[I] never had a heart attack. I always get in here a little ahead of that and they manage to ward that off," he said.

Now, Morton has a blocked heart vessel causing chest and shoulder pain. In past procedures, doctors got to his heart with a catheter through the main artery in his leg. This time, WakeMed cardiologist Dr. Tift Mann will go through Morton's wrist.

Even though the procedure has been available at Wake Medical Center since the early 1990's, only about 5 percent of the cardiologists across the country are using the wrist approach.

"They, just, are uncomfortable starting a new procedure," Mann said.

One challenge is that the wrist artery is about three times smaller than the main artery in the leg. It is a bit more difficult to gain access and maneuver the catheter. However, there is a greater risk of bleeding after procedures done through the leg than through the wrist.

"These days, there are more complications related to the access site than there are to the actual procedure itself," Mann said.

To prevent bleeding after procedures through the leg, the catheter sheath stays in for six hours, and the patient stays in bed for another day. With the wrist, the device stops the bleeding and the patient can walk around immediately. Morton went back home to Louisburg the next day.

"I haven't had any chest pain or any shoulder pain," he said.

Plus, Morton's wound is healing. He said if he has to have the procedure again, he wants it done the same way.

"This procedure is far greater than that procedure going through your groin," he said.

Many devices have been tested to prevent bleeding from the leg procedure, but they have not worked.