Reaching the Heart Through the Wrist

FRESNO, Calif.

Each year, more than a million angioplasties are performed in the United States to unclog the heart's main source of vital blood. But what was once a more complicated procedure performed only through the groin is now being done through the wrist and it requires only a band-aid afterwards. Robert Santopietro looks and feels like a healthy 46-year-old. "I started working out, getting back into shape, New Years resolution," Santopietro told Ivanhoe.

So when he ran out of breath and felt chest pains during workouts, he brushed it off.

"I just put it off to, I ate before I went to go work out, and it wasn't in my chest, it was more in my shoulder," Santopietro recalled.

The pain persisted. Santopietro went in for a stress test, which revealed his problem was much more serious … atherosclerosis. Plaque was building up in his arteries.

"I was shocked to be honest with you that it was happening to me, so scary," Santopietro said.

"That plaque may become restrictive enough that there's inadequate flow, or, more emergently, some degree of clot may form," Michael Azrin, MD an interventional cardiologist at UConn Health Center in Farmington, Conn., explained.

Santopietro needed an angioplasty to unclog his arteries. Instead of the traditional technique, where doctors reach the heart by inserting a catheter through the femoral artery in the leg, Santopietro had a wrist angioplasty.

Doctors thread a tiny balloon through the catheter and guide it into the blockage. It expands and opens the clog. A stent is then left in place to keep the artery open.

"In this country, less than two percent of procedures are done from the wrist," Dr. Azrin said.

One of the biggest dangers of angioplasty is heavy bleeding, which happens in two to 10 percent of patients who have it done through the leg. But one study shows wrist angioplasty cuts the risk of bleeding by almost 60 percent.

"When you're done, you pull the tube out and put a bandage on the wrist, and the patients can sit up. They can walk around. They can return to normal function very quickly," Dr. Azrin explained.

Santopietro's step father Dan had the procedure done less than a week ago.

"Before, I'd get halfway up the stairs and have to stop, and now, I can go all the way," Dan said.

Santopietro is also noticing a difference.

"I feel 100 percent better," Santopietro said. "Knowing what could have happened and didn't happen is just amazing." They're grateful for each moment.

Another benefit unlike angioplasty through the leg, patients who have a wrist angioplasty don't have to lie flat on their backs for several hours afterwards. Dr. Azrin also says the procedure is easier for obese patients because their radial artery is more accessible. He says it's also especially easier to control bleeding in the wrist in larger patients compared to in their leg.

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Melissa Medalie atmmedalie@ivanhoe.com

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