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Trans-radial angiography and Trans-radial Angioplasty. What is the difference between the normal groin approach and wrist approach?


In order to place a catheter (tube) in the artery, we have to enter it as it comes close to your body surface. There are 2 common areas where an artery can be felt as a pulse. These are at the wrist and groin. The size of the artery at the groin may be akin to a ballpoint pen. And the size of the radial artery is like the ink tube within the ballpoint pen. Therefore, it is technically more difficult to access the smaller artery at the wrist. However, after the angiogram, pressure has to be applied to the arteries to prevent bleeding. It is more uncomfortable to have pressure applied to the groin than to the wrist. Furthermore, after the procedure from the groin, you have to rest in bed for about 6 hours without moving your leg. This means for a gentleman, passing urine is a little more uncomfortable.

When the procedure is done from the wrist, the tube is removed immediately after the procedure. Since the groin is not affected, you can walk about immediately. The only precaution is to not do strenuous activities with your hand for next 3 days.

Most patients prefer this method of approach. However, since this is technically more challenging, most doctors use the groin for angiogram and angioplasty. We at Cardiac Specialist Centre use the wrist as 1st choice. The groin is used only in complex cases or if the wrist cannot be used for whatever reasons.

The picture shows the set up for a wrist approach angiogram/angioplasty. The patient has the arm by the side of the body. This is a comfortable position. The whole procedure takes only 10 minutes with minimal pain.

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I feel breathless when walking.

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Do I really need stents for my artery?

Do I really need to have a bypass operation?

When should I go for health screening?

I have heart problem, can I take Viagra?

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You may need an ultra sound scan of your heart to assess its function.

You may need a treadmill stress test.

You may need closer monitoring.

You may need a more thorough risk assessment and life style change.

You may only need to take your medicine.

You may get away with just stenting.

This generally should start at 40 years old.

Yes, but there are certain strict conditions to fulfill.

Yes, but you will need to find out the appropriate intensity.