All in the Wrist

How radial artery angiograms can eliminate hospital stays.

Art by Randall Nelson

The angiogram is a cardiologist’s bread and butter. More than 10,000 catheters are used to treat heart patients every day in the United States. The procedure saves lives—by providing cardiologists with crucial information about the state of a patient’s circulatory system and by providing an avenue for the immediate delivery of stents and angioplasty.

But for those on the receiving end of angiograms, the procedure isn’t as easy as spreading butter on bread. Catheters traditionally have been threaded through a groin vein—an effective but unpleasant procedure that requires patients to be pantsless, shaved, and awake (but sedated) with their limbs strapped down.

Not at HealthEast Heart Care in St. Paul. Thanks to Dr. Thomas Johnson and Dr. Carmelo Panetta, every cardiac angiogram performed here goes through the wrist using the radial artery. As a patient you’re still motionless and awake while it happens, but you’re up and walking quicker, and you’re out the same day.

Panetta has done more than 1,000 radial artery angiograms. His expertise and enthusiasm have driven the shift at St. Joseph’s Hospital. So have the advances in catheter technology—the smallest catheters used to be three millimeters in diameter; in the past two years, that’s gone down to one millimeter.

“St. Joseph’s has done more radial artery angiograms than any other hospital in the area,” Johnson says. And the hospital boasts the largest percentage of doctors dedicated to a radial approach. That’s rapid progress, especially considering that even on the medically advanced East Coast, the majority of cardiologists still go through the groin to get to the heart.

But bragging rights aren’t behind the innovation. Patient satisfaction is. “Most people want to go home on the same day,” Johnson says.

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