Although the femoral artery is large and easily accessed, potential drawbacks include patient discomfort; bleeding complications; the need to keep the patient immobilized for six or more hours after the procedure is completed; and sometimes the need for inpatient admissions of from one to three days.

In an effort to increase patient comfort and shorten the length of hospitalization, cardiologists have recently demonstrated the feasibility and safety of using the radial artery in the wrist, as an alternative. This option has been made possible by the development of smaller diameter catheters and by advances in procedural techniques.

Advantages of using the radial artery include less pain; the speed of the procedure (30-60 minutes); control of bleeding via simple compression of the artery; a less complex entry site; the patient's freedom to walk and move about shortly after the procedure; and the relatively rare need for overnight admission of the patient.

Use of the radial artery for these cardiac procedures began in Europe several years ago and is still fairly uncommon in Florida. Not every patient is a suitable candidate. Because the radial artery is smaller than the femoral artery, the radial-artery procedure requires a higher degree of precision by the cardiologist.

Nevertheless, the advantages of using the wrist entry point are too substantial to be ignored. Although femoral-artery entry will long remain the most commonly used site for cardiac catheters, I believe use of the radial artery will increase steadily in the years ahead, especially in cases where patient comfort and minimal length of stay are especially important.

Richard Sola, M.D., a member of the medical staffs of Mease Hospital and Morton Plant Hospital, specializes in interventional cardiology.