The last time Edsil Prunty underwent a heart catheterization, he was surprised to be able to leave the hospital so soon after the procedure.
"I went in at 7 a.m. and was ready to go at noon. That's what's amazing," Prunty said. "I think this makes my third or fourth one."
Prunty, 60, of Charleston, is a diabetic and has had heart problems since 1998. While the procedure in August wasn't his first catheterization, it was the first transradial catheterization he'd had.
Catheterizations, a procedure to detect or unclog arteries, have traditionally been done using the femoral artery through an incision in the groin. But an alternative to that method - transradial catheterizations, a method that requires an incision in the radial vein in the wrist and to the heart - may have better outcomes for patient.
"It's more comfortable, less bleeding, fewer complications [for patients]," Dr. Donald Lilly, cardiologist and clinical director of Charleston Area Medical Center cardiovascular services, said.
Radial catheterizations have been less accepted in the United States than in Europe and other countries, where nearly 80 percent of caths are transradial. In the United States, 20 to 25 percent of the catheterizations are done through the radial vein. About 20 percent of catheterizations at CAMC are radial.
"It's a little harder to do," said Dr. Dan Foster, a surgeon and former state senator. "It's technically a little more demanding. It does take some time. For someone who has practiced [medicine] 20 to 25 years, changing the way you do something is not easy."
Foster knows about heart catheterizations first hand - 11 years ago he had a heart attack and underwent an emergency heart catheterization and bypass, he said. At the time, he wasn't aware that doctors could use the radial vein for the procedure, he said.
"If I had one again I'd do it this way," he said.
Heart catheterizations are the most commonly done procedures at CAMC; the hospital does 8,000 to 9,000 of them each year, Foster said. That's a reflection of the general health of Southern West Virginia, Lilly said.
"There are these things called cardiac risk factors that increase your chances of having blockages," Lilly said. "The worst of those is cigarette smoking then diabetes, high cholesterol, high blood pressure and you can go on down..."
Physicians have different perspectives about whether transradial catheterizations are the best things for patients. Physicians can use bigger tubes in the groin and certain devices can be used in the groin but not the wrist, Lilly said.
Dr. Shawn Groves, a cardiologist at CAMC, said he does catheterizations through the wrist about 50 percent of the time. The transradial procedure is more technically challenging, and some patients have issues that prevent them from having it done, he said. Groves said CAMC as an institution does transradial catheterizations about 20 percent of the time. Groves said the procedure likely will become more popular at CAMC and in the United States in general.
"If I think the patient is a candidate [for the procedure], I do recommend it," Groves said. "Not everyone is."
There are advantages to the new approach though, the doctors said.
When doctors use the femoral artery, a patient has to stay laying down in a hospital bed for hours after the procedure.
"So if you do [a diagnostic catheterization] from the groin you almost always have to watch them at least eight hours and if you do it late in the day you generally just watch them overnight, keep them, whereas with the wrist you can let them go a lot sooner than that," Lilly said.
Just how soon depends on the physician, he said. With the transfemoral catheterization, patients then have to wear a bandage on the groin which can be uncomfortable.
"With [transradial catheterizations] there's just a little band there," Lilly said. "With this, you can sit up and eat and do whatever you want to."
The bleeding rate from the femoral catheterization is higher than with the wrist, too, he said. Patients of the transradial procedure are less likely to need a blood transfusion, he said.
Foster said the transradial procedure may be better for heart attack patients, too.
"The data seems to show that if you're in the midst of a heart attack, the outcomes regarding survival or other complications of a heart attack are a bit improved," Foster said. "I guess the assumption is since you don't have to worry about bleeding, you can give more blood thinner than you can with the groin."
Evelyn Ellis, 81, of White Sulphur Springs, had a transradial catheterization in August. It was her fourth catheterization and the first time it was done through the radial artery, she said. Ellis said the recovery time after her latest procedure was much lower than it had been with the others. She also didn't develop hematoma, a swelling of clotted blood within tissue, this time like she had in the past.
"I always got hematoma really bad and I had to stay in the hospital," she said of her transfemoral catheterizations. "This time it was easy. I hope and pray if I have to have another one, it'll be the way I go."
Ellis had heard of the transradial catheterizations, and asked her doctor for it by name. Foster said other people may not be aware of the option.
"I think in fairness to the public, they need to be part of the discussion about what's being done and that involves knowing [their options]," Foster said.
Prunty said since his procedure, he has encouraged others to have transradial catheterizations the next time they need the procedure done.
"I've actually told several people about it," Prunty said, adding that when he told people at his church, some had heard about it and some hadn't. "I showed them where they stuck the needle in and it's barely see-able now, just like a little start, a needle puncher. It's healed up beautifully. What's really nice is you can take a shower the next day. Before, you had to wait two or three days."
Reach Lori Kersey at Lori.Kersey@wvgazettemail.com, 304-348-1240 or follow @LoriKerseyWV on Twitter.