Understanding Transradial Cardiac Catheterization
Cardiac catheterization (cardiac cath) is a common, non-surgical procedure. During the procedure, your doctor will insert a long, thin tube (catheter) into an artery and move it up into your heart. Transradial means the catheter is inserted into an artery in the wrist (the radial artery). This procedure can be used to diagnose and treat certain heart problems.
Why do I need a transradial cardiac cath?
You may need a cardiac cath if signs indicate a problem with your heart. These may include:
Symptoms of chest pain, tightness, or heaviness (known as angina). This is a common symptom of blocked heart arteries, known as coronary artery disease.
Symptoms of weakness, dizziness, trouble breathing, or swollen legs or feet. These may be symptoms of a problem with a heart valve or the heart muscle.
Other test results show heart problems. Tests may include stress tests, heart scans, and echocardiography.
During a cardiac cath, your doctor can see the condition of the coronary arteries and heart valves. He or she can also check how well the heart pumps and the flow of blood through the heart. Your doctor can also measure pressures and take blood samples. And, if needed, he or she can open blocked arteries. This can help reduce symptoms of angina.
Cardiac cath is often done using a catheter inserted into an artery in the groin. During transradial cardiac cath, the catheter is inserted into an artery in the wrist. This can mean less bleeding and a faster recovery. Some people may have blockages in the groin arteries as well as in the heart arteries, making it difficult to reach the heart. The transradial approach can be used to get around this problem.
What happens during a transradial cardiac cath?
The procedure is done in the hospital or a surgery center. First, an IV line is put in your arm or hand to deliver fluids and medicines. You will likely be given medicine to relax you and make you drowsy. When the procedure begins:
You lie on an X-ray table.
The skin over the insertion site in your wrist is numbed.
The doctor makes a tiny puncture or incision into the artery in the wrist. He or she then inserts a catheter and threads it through the blood vessel into your heart.
The doctor may inject a contrast fluid through the catheter into the arteries. This fluid makes the arteries show up better on X-rays.
Tests may be done to check the condition of your heart and arteries. If needed, the doctor can clear blockages in the arteries or do other repairs.
When the doctor is finished, he or she will remove the catheter and put direct pressure on the site to prevent bleeding.
You will stay for a time to recover, and then go home.
What are the risks of transradial cardiac cath?
Bleeding, bruising, infection, or blood clots
Damage to the radial artery that may cause injury to the hand
Allergic reaction to the contrast fluid
Abnormal heartbeat (arrhythmia)
Damage to blood vessels or tissues
Kidney damage or failure
The need for emergency heart surgery
Heart attack, stroke, or death
September 05, 2017
Beygui F, et al. Transradial Approach for Diagnostic Coronary Angiography and Intervention. Textbook of Interventional Cardiology. 7 ed. Philadelphia: Elsevier; 2016. p. 516-29., Konstantinos M, et al. Management of transradial access complications in the cardiac catheterization lab. International Journal of Cardiology. 2014 May 15;173(3):521-4., Rao SV, et al. Best Practices for Transradial Angiography and Intervention. Catheterization and Cardiovascular Interventions. 2013 February;83(2):228-36., Schussler JM. Effectiveness and safety of transradial artery access for cardiac catheterization. Baylor University Medical Center Proceedings. 2011;24(3):205-9., Skelding KA, et al. Arterial and Venous Access. Cardiac Catheterization Handbook. 6 ed. Philadelphia: Elsevier; 2016. p. 55-97.
Images Reviewed by Staywell medical art team.,Kang, Steven, MD,Ziegler, Olivia, MS, PA