Cardiac Cath: Wrist or Groin???

[susieq14]

My husband saw an interventional cardiologist today at a large teaching hospital in Boston and is scheduled for a cardiac cath next Thursday, October 22. (This is because of reduced blood flow and an abnormal EKG on his nuclear stress test.)

At the very end of the exam and discussion the cardio told us that my husband had the option of having a traditional cath which goes from the femoral artery in the groin up to th heart or a newer version starting in the arterial artery in the wrist. He suggested that this method involves less time to stop bleeding than the groin puncture which requires 4 - 6 hours lying flat. He said using the wrist is successful 98% of the time - for 2% of patients there is sometimes a problem getting through the shoulder area and then they need to restart using the groin. If it goes though okay then the whole procedure is done as it would have been done starting in th groin. an angioplasty and stent can also be done this way.

Has anyone had a cath using the wrist instead of the groin? Anyone have any suggstions or advice? We don't have to tell the doctor until Thursday morning.

Thank you.

P.S. For those of you who read my prior post (Who does Cardiac Cath?)and the dilemma we were having about leaving our local cardio and going to Boston, we are happy with our decision. We're glad that we decided to. We loved this doctor and his interventional fellow who examined my husband first. My husband felt so at ease with them - well not totally he's still nervous about the whole thing - but they semed to be so concerned and caring.

 

[mainframe]

I just had one using the groin, but my cardiologist had the option of only having be still for 2 hours instead of the 4. He chose 4 for me (figures) but the guy in the bed next to me only had to lay still for 2 hours. I know some cardio's are using the wrist, mine didn't give me that option.

 

[Freddie]

I have, I have. I've had it done in the wrist. It was pain free and no bruising. Best of all I could walk around 30 minutes after it was done. The only restriction was not to use the wrist for a few days. They did it in my right wrist and I'm right handed, but I was still able to feed myself and lift a cup to drink that same day.
Yep, the wrist, with no complications- I highly recommend it.

P.S.
I think I'm the only one here that has got it done in the wrist.
Also, I have no scar.

 

[Adrienne]

I had the traditional groin cath, but I would have loved to have had the wrist one!! The 6 hours lying down and not being able to pee in a bed pan was horrible (I'll spare you the details). So, I think that despite the 2% risk that they would have to start over and do the groin one, I would try the wrist cath if I had the choice.

 

[Jkm7]

I had groin cath closed with angio-seal (plug) and had to lay flat for about 2 1/2 hours. I had no bruising, no pain, no swelling, nothing. I was totally fine and amazed how easy the whole thing was after all my stressing about it. I was able to go about my usual activities the next day and did so pain free.

I feel very strongly the skill and experience of the Interventional Cardiologist doing the cath makes a huge difference in this particular procedure.

 

[tcopel]

i have not actually talked to anyone that has had the wrist approach. It may be latest greatest thing. However, like anything new in the medical field, I would probably need to be reassured that the doctor has had adequate experience. THe more experience, the better the probability of a good outcome.

 

[Philip B]

Cath?

Cath?

About thirty years ago, a cardiologist was going to use my arm as an access point for a heart cath. The wrist technique may be a new twist on the technique he planned to use on me. He changed his mind and decided to go through my groin instead because he wasn't sure going through my arm would be successful.

About the only thing that seemed to have change about the heart cath stuff when I had one twenty-seven years later was their use of a collegin (that's probably misspelled) plug to plug the hole in my groin after they finished. The plug reduced the time I had to lay still. The plug eventually dissolved.

I really wish they could develop a less invasive method for getting the kind of information they get with heart caths.

-Philip

 

[Cozycat]

Sounds like using the wrist is a good way to go. I didn't have that option either, but going in through the groin wasn't bad. I was just so happy to have it done so they got a good look at what needed to be fixed and what was okay. I hope your husband is able to see the screens that show what is going on inside your heart....very fascinating even though I didn't know what it all meant. It was just a bit of a thrill to think, "I'm looking at the inside of my own heart. How great that is!"

Wishing you guys much success with the cath.

Midge

 

[OldManEmu]

Groin cath

Groin cath

I wasn't offered a choice.
I can't say I found a groin cath any great deal.
I had a nurse hold preasure on the point for about 30 minutes post procedure.
To my knowledge there wasn't anything other than preasure used to close the point of access for the cath.

 

[susieq14]

after a long weekend of googling we are still up in the air about how my husband wants to have his cath done.

I found lots to read and it seems that those in favor of using the wrist are passionate about it and those against are just as passionate about not using it. such as in the follwing article in the Washington Post last month:
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/21/AR2009092103102.html


Makes it very difficult to make a decision for two laymen.

I found that of the 1.2 million caths done in the US only 1% are done thru the wrist instead of the groin. However, in Europe 50% are done each way.

I have a list of questions and will be calling the hospital tomorrow to try to talk with the cardio or perhaps the Interventional Fellow that also examined my husband and gave us some information at the appointment.

thnaks to all of you for sharing your thoughts and experience.

 

[mamanordy]

I just had cardiac cath Thurs, they used my femoral artery in groin. I felt fine in a couple days. A little tad of pain there but not enough to cause a lot of discomfort. Hope your husband will be feeling better soon!

 

[Lynlw]

after a long weekend of googling we are still up in the air about how my husband wants to have his cath done.

I found lots to read and it seems that those in favor of using the wrist are passionate about it and those against are just as passionate about not using it. such as in the follwing article in the Washington Post last month:
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/21/AR2009092103102.html


Makes it very difficult to make a decision for two laymen.

I found that of the 1.2 million caths done in the US only 1% are done thru the wrist instead of the groin. However, in Europe 50% are done each way.

I have a list of questions and will be calling the hospital tomorrow to try to talk with the cardio or perhaps the Interventional Fellow that also examined my husband and gave us some information at the appointment.

thnaks to all of you for sharing your thoughts and experience.

I think IF you don't have a strong preference, I would ask the person doing the cath which way THEY prefer and since as you have them as your doctor and must trust their judgement some what, go with what they suggest

 

[Waggily Tail]

Hi susieq, My husband had his cath at MGH last month 2 weeks before his AVR. MD said if his pulse was good they'd go in through his wrist and carotid. It worked out as expected, and that night we actually enjoyed a nice Italian dinner in the north end, even though his procedure was delayed until the afternoon (and we watched everyone else getting admitted for the night). If the cardio feels this is a viable option, then I'd say go for it. Bill had very ittle discomfort. Good luck to you, Jill

 

[westie]

patients choice?

patients choice?

.
for me, there was no suggestion i could choose wrist or groin. the cardiologist looked at my viens and said, great, and did the cath there. i was happy about that as i understood, correctly, that the closure of the wound there was much quicker and certain.

the surgeon said cardiologists prefer the wrist as it is quicker, but they can "stuff it up" and he said surgeons tend to think the groin is a better location.

beware of the possible "stuff up", you can end up with zero pulse in the cathed arm; i am not the only person here with that side effect.

 

[susieq14]

more thanks Mamanordy, Westie, Jill and Lyn for sharing your thoughts and experiences.

We were told today that Joe has the first appointment Thursday morning at 7:30. We have to check in at 6:00 which is good for him - less time to be hungry and less time to worry. Less time to sleep too - we'll be leaving the house at 4:30 - although sleeping hasn't been easy for either one of us lately.

I know it is not OHS and not anything compared to what you have all been through but it is still a very big deal for us. And it is so crazy because I thought I was going to be the patient someday but instead I'm trying to be strong for him. It is tricky being the significant other watching and waiting and trying to be there for him. Lyn - I can't imagine how you have dealt with all you have had to with your son. That must take another whole level of courage and whatever to deal with a sick child.

Well enough of my rambling. But I'll never stop saying thank you to all of you here.

All my best to all of you!

 

[Kevin]

sorry this comes a bit late.
just had angiogram yesterday. they went through wrist. previously, I have had two others through groin.

Wrist was waaaay easier. Faster recovery and less discomfort during procedure.

Personally, I would just go wtih whatever your docs choose for you.

They usually do femoral for certain cases, but in some they say they can go either way.

Not a tough procedure either way.

Good luck!
Kev

 

[james]

Just had the groin done yesterday. Holy crap this has wiped me out. Really surprised by the effect this little thing has had on my body. They were in me for less that an hour.
Should there be a baseball sized bruise there today? No giant lump just a big bruise.

 

[Lynlw]

Just had the groin done yesterday. Holy crap this has wiped me out. Really surprised by the effect this little thing has had on my body. They were in me for less that an hour.
Should there be a baseball sized bruise there today? No giant lump just a big bruise.

Yes, big flat black and blue bruises are very common. Were you pretty much knocked out or awake? Sometimes the meds wipe you out, Justin never has them a wake so I don't know if that still wipes you.

 

[TXWildflower]

I didn't get a choice, but I think I would have preferred the wrist. I have a problem with my sciatic nerve and lying flat on my back causes my thighs to go numb. IThis just exacerbated the problem and the discomfort was 10 times worse. I have had many chiropractic visits afterwards trying to decompress that nerve area. I am happy to say that after a couple of months it is much better now.

I was so out of it I really didn't see much on the screen - I'm bummed about that now. Other than the lying flat - the cath was a piece of cake. I didn't even have any heavy bruising. They used the collagen plug that I guess by now has dissolved. The hold was so small I never really could see it. Jus some very slight bruising around it.

 

[susieq14]

My husband's cath is now history. We were very lucky that no blockage was actually found. The cardio called me from the procedure room when he was done and told me that he saw some plaque build-up and narrowed arteries but not a blockage. He also mentioned something about arterial spasms. The Interventional Fellow came to see Joe in the Recovery Room and he gave him a prescription for Diltiazem, a calcium channel blocker to help dilate the vessels in addition to his lisinopril and simvastatin. They set up a follow-up appointment for November 11. I'm looking forward to getting more details then.

Joe chose to have the procedure thru the wrist access and it was a success. His Cardio who is the Director of the Cath Lab and his Fellow were
both so confident and positive that it would be easier for him that Joe agreed. Joe arrived back in the recovery room a little after 10:00 and was told he could probably leave at 1:00. They had a tight band around his wrist and he had to keep his arm raised on 2 pillows. He dozed off and on - he was quite exhausted. He was discharged at 1:30 and they sent him home with a sling as a reminder to not use his right hand/arm to lift anything heavier than an 8 oz cup of coffee. He said his hand/wrist hurt a little last night - he thought perhaps the local anesthesia was wearing off.

Joe was exhausted yesterday and today. We arrived home at 3:00 and he took a nap until 6:30. Today he even went back to bed after breakfast and slept for another 3 hours. He's been in all day and just kind of vegged out. I think we were both wiped out - from the anxiety and worry about the whole thing i.e. what the procedure would be like and what it would find. Joe didn't find the cath to be too bad - he thinks he was pretty sedated because he doesn't remember much. He told his nurse that it felt like it had only been 20 minutes long and he was surprised when she told him it had been 90 minutes.

One reason it was a little longer than a normal cath is that they asked Joe if he would consider being in a research study and he said yes. They are trying to develop a method to study the arteries of the heart without doig an invasvive cath. so they took one extra x-ray and some ultrasound pictures and he has to go back next week to have a 320-slice CT - supposedly BWH is one of only a few hospitals to have one of these machines. Anyway Joe thought that maybe it will help someone in the future.

By the way if anyone is considering BWH in Boston, we would recommend it highly both as a patient and waiting family member. We were quite impressed with the staff and the whole set-up. The new Cardiovascular building is quite impressive and so patient and family friendly.

Thanks again and best wishes to all!