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Cardiovascular Services
Cardiac Cath Lab
St. Clair Hospital’s cardiac cath labs are full-service, providing complete cardiovascular care 24 hours a day, 365 days a year. The lab has successfully performed thousands of procedures, including coronary stent insertions.
A patient undergoing a heart catheterization at St. Clair Hospital now has the option of having the procedure performed through the radial artery in the wrist instead of the traditional femoral artery in the groin.
While entry through the femoral artery is still the most common approach of the approximate 2,000 cardiac catheterizations performed each year at St. Clair Hospital, Cardiologist Jeffrey M. Friedel, M.D. says a so-called “radial cath” through the underside of the wrist offers two major advantages.
“For a traditional heart cath through the femoral artery in the groin, a patient often requires prolonged bed rest of 4 to 6 hours following the procedure, especially if the patient undergoes angioplasty or stent placement,” Dr. Friedel says.
“With a radial cath, you can remove the tube, place a small bandage on the artery, secure it with a special, adjustable wristband, and the patient can literally walk off the table. There is no prolonged bed rest. This also holds true if the patient is onlong-term blood thinners, including Coumadin. Unlike traditional catheterizations via the femoral artery, you do not have to stop Coumadin several days prior to the procedure.”
The other advantage is safety. Dr. Friedel says several studies that compared the two methods showed that a catheterization through the wrist offers up to a 75 percent reduction in bleeding risk. “The radial artery is smaller, and if you do have bleeding, it's much easier to control. The risk of blood vessel injury is also less compared to the femoral approach.”
Dr. Friedel says a catheterization through the femoral artery is still a very safe procedure and is the preferred method of most cardiologists. In fact, today about 99 percent of the 1 million-plus heart catheterizations done annually in the U.S. are performed through the femoral artery.
But, Dr. Friedel adds, that is due in large part to the fact that most invasive cardiologists were trained to do cardiac catheterizations through the femoral artery and have become very proficient at that method. There is a significant learning curve for performing a radial cath, and it is not yet a standard part of every training program.
What’s more, the original catheterization equipment was larger. “Simply put, the tubes were too big to place into a small artery in the wrist,” Dr. Friedel explains. “As the procedure evolved, all of our equipment has gotten smaller and now the tubes we use are only several millimeters in diameter and can easily fit into most radial arteries.”
Dr. Friedel notes that, aside from the different access point into the body, femoral and radial caths are very similar. “The majority of the procedure is the same: injecting dye into the coronary arteries (to detect blockages and other abnormalities), doing an angioplasty (in which a small balloon is inflated inside the artery to re-open blockages) and placing stents (small mesh tubes used to keep the re-opened arteries from collapsing).
Dr. Friedel, who has been doing radial caths since 2001, says the radial method is of particular benefit to patients with orthopedic limitations, including severe back, leg and knee pain—people who, in general, can’t lie flat for a prolonged period of time. It’s also more comfortable for obese patients or patients with significant lung problems. And, he says, it is an excellent alternative for patients with significant blockages in the larger arteries of the abdomen or lower legs.
Not every patient is a candidate for a radial cath, Dr. Friedel says. The main prerequisite is good circulation in the wrist arteries. A non-invasive test that takes seconds and is performed at bedside can determine if a patient’s circulation is good enough for a radial cath.
Of the approximate 400 cardiac catheterizations he performs every year at St. Clair, Dr. Friedel says he does about 20 percent through the radial artery. His goal is to increase that rate to about 50 percent per year, approximately the same rate of radial caths performed annually in Europe and Japan.
Other cardiologists performing radial caths at St. Clair are Drs. Mark K. Greathouse, Adil Waheed, and John P. Girod. Click here for a closer look.
Procedures performed in the lab include:
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New Services:
- Electrophysiology Studies
- ICD insertions
- Cardiac Ablations
- Tilt table
With 24-hour emergency service, the lab has treated more than 1,000 patients suffering from heart attacks and holds the distinction of having the best treatment time for patients experiencing acute heart attacks. The Cardiac Cath Lab offers patients the most advanced technology for the diagnosis and treatment of cardiac disease.
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