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Slender transradial angioplasty performed in India for first time

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Achieving yet another feat for Indian medical expertise, cardiologist Dr Sanjay Chugh performed the country’s first slender transradial angioplasty, for the first time in the world outside Japan, during the upcoming 3rd ‘World Radial Meet’ at Fortis Memorial Research Institute here.

Transradial angiogram or angioplasty is conducted through wrist arteries instead of traditional route of access through the groin and is being widely accepted across the world as a revolutionary approach with tangible advantages for patients, including reduced complications, increased patient comfort and quicker recovery time.

Dr Chugh, Principal Consultant, Interventional Cardiology, FMRI, Gurgaon, said, “The 62-year-old patient had visited us with problem of chest pain initially. He came to us two weeks back. After examining we found their were two blockages in his heart. Though transradial is becoming popular, there were limitations due to lack of expertise and inadequate tools to conduct such procedures in patients with slender (thin) wrist arteries. So far such a case has been done in Japan only. Today we performed this breakthrough procedure for the first time in India during the 3rd World Radial Meet that is being attended by experts from Japan as well as other parts of the world.”

Dr Chugh further said that the special equipment were sourced from Japan to perform this procedure. The procedure was telecasted live to a host of cardiologists who assembled from various parts of the country. These doctors together formed India’s first Slender Transradial Club that was launched during the first day of the conference.

The conference, christened as Radial Live 2013, brings together renowned academicians from India and researchers from Japan, Canada, the US and France. It focuses on sharing the latest updates in the world of Cardiology and Live Radial Angioplasty Workshops.

“The first transradial diagnostic was performed by Dr Lucien Campeau, a French/Canadian physician, in the late 1980s. However, the first transradial Angioplasty was performed by Ferdinand Kiemeneij in 1992. In recent years, the method has grown. Transradial technique is much safer as the vascular bleeding reduces to 1/10th of the amount of bleeding in normal angioplasty. Also, the time to ambulatory recovery is 1/3rd as compared to cronary angiography through conventional access by groin, said Dr Chugh.

“Transradial is essential in at least three to five per cent of cardiac patients who are not fit for traditional (femoral) angiography due to lower limb problems, blocked arteries, obesity or being on blood thinners. It is preferred as it promises quick recovery time. Patients need not to suffer from back pain, urinary retention requiring catheterisation,” he added.

The transradial approach reduces a patient’s hospital stay, often significantly, and consequently lowers the overall cost incurred by the patient as well. Further, the ambulation in the case of patients who have undergone this procedure is much quicker. In fact, such patients walk into and walk out from the Cath Lab post procedure. The mortality rate for Transradial PTCA has been shown to be significantly lower, particularly in the case of those patients with heart attack situation. This procedure is also associated with a lower rate of major bleeding and access-site complications, as well as a significant increase in net clinical benefit.

Transradial approach decreases incidence of major entry site complications and excessive bleeding. It also minimises risk of nerve damage, which is common in the femoral approach due to the close proximity of the femoral artery and nerve; easier vascular access for interventional cardiologists and closure of the needle puncture in certain patients, such as those who are overweight or obese; significantly decreased time to patient ambulation and discharge.

EH News Bureau

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