- As part of our commitment to improving patient care
at Wake Forest Baptist Medical Center,
those of us physicians in the heart center
who perform these procedures,
as a group decided that we were gonna make a transition
from using the femoral artery as our preferred access
to the radial artery as our preferred access.
Because of that, the entire staff, both the physician side
and the medical side, made a huge commitment in terms of
education, time and effort.
And because we went through the sort of growing pains
of a program that was dedicated
to transradial artery catheterization,
we were able to achieve, I think, some efficiencies
and excellence that allowed us to perform this
in the vast majority of our patients now.
We started this procedure about two and a half years ago
in an attempt to improve the quality of care we provided
to our patients coming to the cath lab at the heart center.
In those two years, we've performed probably over 3,000
transradial cardiac catheterizations
and we feel have gained a tremendous experience
and satisfaction in performing this procedure.
When we embarked on this program of transitioning
to a transradial catheterization as our preferred strategy
for this procedure, we realized that we needed
to have a broad-based effort that included,
not only the physicians, the fellows, and the staff,
but clearly the patients and their families themselves.
So we set up each of the labs identically
with the basically the equipment that allowed us
to perform this in a simple fashion.
We actually stopped prepping the femoral arteries
so that we could show the confidence that we had
that we were going to actually perform this
in most of our patients.
And the last part of this was is that
in the recovery areas, we had special unit built
that really embodied the less invasive, I think
safer procedure.
We've called this the radial lounge,
other people call it a radial recovery area,
but there the families and the patients
are able to recover in a sitting position
with a simple hemostatic band on their wrist.
And because of the lighter anesthesia and sedation we use,
they're able to get up and move around much more quickly.
Yeah, we think the vast majority of patients
can undergo a diagnostic heart catheterization
through the radial artery with either
four or five French catheters.
There are procedures, of course, that involve
coronary interventions sometimes,
non-coronary vascular interventions that require
tube sizes, catheter sizes that are much larger
than can be accommodated through the radial artery.
Many of these we try to identify ahead a time
so that we know that femoral access
is the route that we need to take.
Our heart center, and particular the transradial program,
has really shown to us that it's important assume
a leadership position in this area
and to that end, we have acted as a training site
for other hospitals that are interested
in making the transition.
We've had physicians come and visit us and watch us
and sorta get first hand experience of the procedure.
The staff have come from other hospitals,
work closely with our staff, seeing all the details
and the steps that we take
to make this a successful procedure.
We're also looking at a cost effectiveness of the equipment,
the time that it takes to perform a catheterization
through the radial approach
as well as the femoral artery approach.
We've just successfully presented
an abstract at the TCT and have others submitted
for the American College of Cardiology.
So through our clinical research, we are trying again
to remain in the forefront of efforts
to make transradial catheterization the best possible.