Craigorian Chant

WASHINGTON - The best path to a clogged heart may be through the wrist. About a million artery-clearing angioplasties are performed in the United States each year, and the usual route is to thread a tube to the heart through an artery in the groin.

Now a major study shows going through the wrist instead can significantly lower the risk of bleeding — without the discomfort of lying flat for hours while the incision site seals up.

Just one in 100 angioplasties is done via the wrist, and the approach isn't for everyone. But Monday's study promises to spur more specialists to use the method.

"In experienced hands, it can be done more," said Dr. Sidney Smith, heart disease chief at the University of North Carolina at Chapel Hill and a past president of the American Heart Association, who wasn't part of the study. "This approach, when done by experienced operators, has advantages."

Angioplasty is prized as a quick, minimally invasive way to restore blood flow in a clogged artery. A tiny balloon is inflated at the site of the blockage, pushing back the clog. Doctors often also insert a mesh tube called a stent to keep the artery propped open. It can be done during a heart attack, to alleviate worsening symptoms that signal a heart attack is imminent, or for nonemergency relief of recurring chest pain.

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Who's the best candidate for an angioplasty versus other treatments is hugely controversial. But once that decision has been made, the new study addressed whether the through-the-wrist route works as well.

Cardiologists have preferred working through the femoral artery in the groin because it is a larger blood vessel than the wrist's radial artery, easier to tug catheters through. When the procedure's over, heavy pressure — often a sandbag — is applied for several hours until the puncture site quits bleeding and essentially seals itself. But heavy bleeding and related complications are a risk, happening in anywhere from 2 percent to sometimes as many as 10 percent of patients.

Catheters have Acheter Cialis gradually gotten smaller and more flexible, and previous small studies had suggested the wrist approach could be safer because that puncture site can be bandaged comprar viagra. In one earlier study, the wrist method even trimmed hospital costs because

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(Reuters)
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