A Simple Explanation
These are the angioplasty procedures that use the Radial and Ulnar arteries as the entry site for the catheterization procedures.
What is it?
Doctors use the Femoral artery as the common catheter insertion site in Coronary Angioplasties. But nowadays, cardiologists are leaning towards the multivessel radial and ulnar arteries as the insertion sites.
What is a Radial Artery?
Radial Artery is the main artery of the lateral aspect of the forearm, i.e., or the farther part of the forearm. It lies in front of the distal end of the radius, the large bone in the forearm. In other words, it originates from the brachial artery just below the elbow crease, passing laterally along the forearm and ending at the wrist.
The radial artery is used for
- Coronary Artery Bypass Grafting
- Coronary Angioplasty
- To obtain Arterial Blood gas
- For insertion of an arterial line, for blood pressure monitoring in an ICU.
- The pulse or the heartbeat
What is an Ulnar Artery?
Ulnar artery is the main blood vessel with oxygenated blood, located in the medial aspect of the forearm, i.e., near the middle of the forearm. It arises from the brachial artery, the major artery of the arm, and terminates in the superficial palmar arch, which joins with the superficial branch of the radial artery.
Advantages of Radial and Ulnar Angioplasty
- Due to presence of 2 arteries, there is dual blood supply to the hand, minimizing the potential for hand ischemia, lack of blood to the hand.
- Helps as access for patients with aortic aneurysm, enlargement of the aorta.
- The patients do not need prolonged bed rest after this procedure
- It is easy to compress the catheter insertion site and achieve hemostasis, stopping of bloodflow.
- Lesser vascular (blood vessel) complications compared to the femoral approach.
Risks of this Approach
Like any invasive procedures, this approach too has some risks, like:
- The radial artery is smaller in diameter than the femoral artery
- Vessel spasm
- Insertion of the catheter is a little difficult and is time-consuming.
- The patient’s blood is tested with the diagnostic tests, like blood pressure, ECG etc.
- Then they check if both the arteries, radial and ulnar are working and once confirmed, then they proceed.
- The procedure can be conducted from any wrist, left or right.
- Both the groin (femoral artery) and the wrist (radial artery) areas are made ready, if complications arise in the radial artery approach.
- Local Anaesthesia is applied to the wrist area and a sheath is inserted into the radial artery.
- Then a catheter is inserted through this sheath and guided to the heart and coronary angioplasty and if required, stenting is also performed.
- After the procedure, catheters and the sheath are removed from the wrist.
- The compression device is placed on the wrist to prevent bleeding.
- Patient can sit up and eat.
- Patients are advised not to put unnecessary stress on the wrist, till it heals.
- Patient is also advised to avoid lifting heavy objects.
- Patient will be able to use the wrist for activities like eating, writing etc.