Patient Safety: Radial vs Femoral

Cardiac catherization options have key differences.

Dr. Imran Dotani

McFarland Clinic cardiologist Dr. Imran Dotani
evaluates every patient to determine the
best method. He says the radial method is
possible, and the best option, in about
95 percent of cases.

Currently there are two preferred methods to performing a cardiac catheterization. Physicians either access the vessels of the heart by inserting a catheter into an artery in the groin area (femoral) or the wrist (radial). Image resolution is nearly identical using either access point, and both are extremely safe. The radial method, however, is a bit safer for a few reasons.

First, the arteries of the wrist are much easier to access than those in the groin. The femoral artery is approximately the size of a thumb and located deep within the groin, while the radial artery typically is smaller than a pencil and close to the surface of the skin.

Second, the radial artery is much easier managed after the procedure. Closing the femoral artery requires 20 to 30 minutes of firm pressure directly over the puncture site and/or the use of closure devices or sutures. Closing the radial artery requires only a plastic band, which looks like a bracelet with a pillow inside. It is placed over the puncture site, closed with Velcro, and then inflated to create enough pressure to seal the artery. The band stays on for approximately two and a half hours.

Finally, recovery time is reduced with the radial procedure. The femoral catheterization requires patients to lie flat on their backs with minimal movement for four to six hours. Once patients are discharged from the hospital, activities of daily living are extremely limited for as long as a week. On the other hand, patients having the radial catheterization have complete mobility and can go home in as few as two to three hours. During recovery, they can sit up in bed, take a walk, use the restroom, and even eat a meal.