A stent is a tiny scaffold resembling the spring inside a ball-point pen. It is used to hold a blood vessel open. During the procedure, a collapsed stent is placed on a balloon catheter and moved through one of the two arteries in the wrist (the artery where the pulse is usually felt) to the coronary artery where it is needed. The stent is then expanded by the inflating balloon which is later deflated and removed.

"The big step forward is not so much that we're doing a different procedure on the heart, but that we're doing it from a much different access area," explains Dr. Simonton. "The risk of a complication such as bleeding or bruising from this site is much less than when we use the large artery in the leg.

"Patients can sit up immediately after the procedure is finished," he adds. "There's no need for prolonged bed rest as there is when access is made through the leg." Patients can walk within a couple of hours of leaving the cardiac catheterization suite instead of being required to lie still for eight hours, and patient comfort is dramatically improved. That means less intensive nursing care is required, a shorter stay in the hospital, and resulting lower costs.

"About half of the cath procedures we do are balloon angioplasties or the placing of stents, and both are easily performed in this manner," Dr. Simonton says. A majority of catheter patients are candidates for transradial access, though they must have adequate blood flow through the arteries in the hand to be eligible. "For procedures that require larger catheters, such as rotablators and atherectomies – removal of plaque from the inside of the artery – we still gain access through the leg."

According to Dr. Simonton, there is a good possibility that in the near future that catheterizations via transradial access will become outpatient procedures.

Ferdinand Kiemeneij, MD, PhD