For years, people suffering from cardiovascular diseases undergo angiogram, a procedure used to assess any blockages in the heart's arteries. The procedure entails a catheter inserted in the femoral vein in the groin and up to the heart. However, a new research suggests that using the artery in the arm is safer than the groin to prevent risk for major bleeding and death.
The study recommends an alteration in the invasive procedure and prompt re-evaluation of clinical guidelines and that the arm, should be preferred as an approach for all catheter-based heart procedures including angioplasty and angiogram.
They presented their study on March 16 at the American College of Cardiology 64th Annual meeting in San Diego, California. Dr. Marco Valgimigli, senior author and senior interventional cardiologist at the Erasmus University Medical Center in the Netherlands said he would push to have guidelines changed to favor the radial approach.
The researchers analyzed and studied 8,400 patients at 78 hospitals in four European countries who underwent angiogram. Their findings show that there was no reduction in certain aspects related to its side effects like the rate of death, heart attack or stroke 30 days after catheterization. However, it showed a significant reduction in one major complication of this procedure which is bleeding. Patients who underwent the procedure via their femoral artery had more chances of bleeding than patients who had their arm used in the procedure.
For patients whose arms were used, the rate of complications within 30 days was 9.8% while in those whose femoral arteries were accessed, the rate was 11.7%. Meanwhile, major bleeding were at 1.6% for arm patients and 2.3% for groin patients. That is why physicians usually recommend pressure on the groin area for 24 hours after the procedure because the risk of bleeding is high.
"This study shows that interventional cardiologists who are experienced with the radial approach have nothing to lose and everything to gain by using the arm as the access point for these procedures," he said. It would include lesser complications, lesser hospital days stay and lesser costs.
With the faster rate of recovery, patients would be able to save a lot from medical expenses. Furthermore, the study was funded by Gruppo Italiano Studi Emodinamica (Italian Society of Interventional Cardiology), which received research grants from Medicines Company, the maker of Bivalirudin, and the medical device company Terumo.