Lower bleeding risk in wrist entry for angioplasty: study

Doctors could spare angioplasty patients major risks by operating through the artery in the wrist rather than the leg, as has been the standard US practice for decades, researchers said Monday.

Fewer than five percent of angioplasty operations in the United States are currently done through the radial artery, but a randomized international trial showed that radial and femoral methods worked just as well.

Even more, wrist entry involved about a 60 percent lower risk of major bleeding and related complications, the study said.

The findings of the RIVAL trial, which studied 7,000 patients with acute coronary syndrome in 32 countries, were released at the American College of Cardiology conference.

Radial surgeries showed fewer blood clots at the entry site and other vessel complications that can lead to survival risks and pain in the patient, said lead researcher Sanjit Jolly of McMaster University in Ontario, Canada.

"The implication for practice is that both approaches are very safe and effective," he said.

With radial access, "there was a more than 60 percent reduction in major vascular access site complications."

However, it may be difficult for American patients to take advantage of the findings, because doctors in the United States tend to prefer femoral access, and are lagging behind Europe and Canada when it comes to radial entry, Jolly said.

"In some countries we are seeing rapid movement toward radial, in other countries it is a slower process," he said.

Some studies have shown that doctors in France and Canada are performing as many as 90 percent of angioplasty procedures via the radial artery, he said.

Angioplasty is performed by inserting a tiny balloon attached to a wire into a main vessel of the patient. Doctors then guide the balloon to the clogged region near the heart and expand it so that blood can flow better.

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