Cardiac catheterization is a medical procedure your doctor can use to perform tests and treatments. In this test, a thin, flexible tube (called a catheter) is inserted into a blood vessel in your arm, groin, or neck and then threaded to your heart. Once there, your doctor can use the catheter to perform tests and treatments. For example, your doctor may inject dye into the catheter and take X-rays of your heart to test your arteries and look for plaque (coronary angiography). Your doctor may also look for blockages in the coronary arteries with ultrasound or take samples of heart muscle or blood. You’ll be awake during this procedure, but you won’t be in pain. After the procedure, you may have soreness in the area where the doctor inserted the catheter.
Cardiac caths provide information on how well your heart works. It identifies problems and allows for procedures to open blocked arteries. The following examples are some benefits to cardiac caths:
Take X-rays using contrast dye injected through the catheter to look for narrowed or blocked coronary arteries. This is called coronary angiography or coronary arteriography.
Perform a percutaneous coronary intervention (PCI) such as coronary angioplasty with stenting to open up narrowed or blocked segments of a coronary artery, especially someone with CTO (Chronic Total Occlusion)
Check the pressure in the four chambers of your heart.
Take samples of blood to measure the oxygen content in the four chambers of your heart.
Evaluate the ability of the pumping chambers to contract.
Look for defects in the valves or chambers of your heart.
Remove a small piece of heart tissue to examine under a microscope (biopsy).
Cardiac catheterization is a minimally invasive procedure generally employed to diagnose and treat certain heart conditions. It involves threading a thin flexible tube through a blood vessel to the heart. Your doctor can perform diagnostic tests and some procedures on your heart with the help of the catheter. This procedure is typically performed through the groin or femoral artery. Because the femoral artery is larger and offers a direct route to the heart, it has become the dominant approach to cardiac catheterization. However, recently, the use of radial artery for cardiac catheterization procedure has increased drastically. The radial artery approach is safer for patients as it is associated with less bleeding and fewer complications compared to the femoral approach.
Radial artery catheterization offers several benefits such as:
Less risk of nerve injury
Lower rate of complications
More comfortable for patients as they can move around immediately after the procedure, instead of staying in the bed for several hours
Before the procedure, the blood supply of the radial artery of the patient's hand is assessed through an Allen test. There are 2 arteries (radial artery and ulnar artery) that supply blood to the hand. The catheterization procedure is safe to proceed only if both arteries are working properly. This approach is not appropriate for patients who are extremely thin or have small or twisted arteries.
The common steps involved in radial artery catheterization are as follows:
You will be asked to lie flat on the operating table and a medicine will be given to help you relax.
A local anesthetic will be injected to the wrist to numb the area.
A small tube (sheath) is inserted into the radial artery.
Medications are given through the tube to help relax the radial artery. This may cause a temporary burning sensation in the hand and arm.
Blood thinners are also administered to help prevent the formation of blood clots within the artery.
Then the catheters are moved through the tube and guided to the heart.
If required, a coronary angiogram and stent placement may be performed.
After the completion of the procedure, the catheters and tubes are removed from the radial artery.
The patient is advised to wear a compression device on the wrist, usually for 2 hours following the procedure. Patients are able to sit up and eat after the procedure. Patients can resume their normal activities after 48 hours.
Common post-operative instructions after radial artery catheterization are as follow:
Avoid placing any undue stress on the radial artery, to aid in healing.
Avoid lifting heavy weights with your hands.
Radial artery catheterization is generally a very safe procedure. However, as with any medical procedure, there may be some risks and complications involved. Possible risks and complications associated with radial artery catheterization include:
Although rare, spasm of the muscles lining the wall of the radial artery can occur.
Occlusion of the radial artery caused by blood clot formation within the artery may occur. This is usually harmless and may be prevented by using blood thinners.