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Examiner
  • The way to the heart is through the wrist

  • Dr. Daniel Dunker, a cardiologist at St. Mary’s Medical Center, specializes in a catheterization procedure that is safer and more comfortable for patients.

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  • Dr. Daniel Dunker, a cardiologist at St. Mary’s Medical Center, specializes in a catheterization procedure that is safer and more comfortable for patients.
    It’s called transradial catheterization.
    It’s Dunker’s specialty, and he’s the only physician in Eastern Jackson County who performs the procedure.
    Transradial catheterization involves threading a small tube through the artery to check for blockages or other conditions. Traditionally, catheterization is done through the large femoral artery in the groin.
    During transradial catheterization, the surgeon threads the tube through the small radial artery in the wrist.
    The procedure is becoming more popular among cardiologists, namely because of the many positive advantages for the patient.
    Those advantages include faster recovery, less post-surgery discomfort, less time in the hospital and less risk of bleeding during surgery.
    Perhaps the biggest advantage is decreasing the risk of bleeding while on the operating table. This is particularly important for obese patients, which Dunker said the procedure is “tailor made for.”
    Trying to hold pressure on the insertion spot in an obese leg can be challenging when going through the femoral artery.
    “If you’ve got somebody who’s very large then just trying to find the artery is difficult,” Dunker said.
    “When you find it and get into it, now you’ve got a hole the size of a pencil in a major artery and then you’re going to ask someone to put pressure down on that and try to stop the bleeding? I don’t think so.”
    In the new procedure, a band is wrapped around the wrist to stop any bleeding, which is usually less because of a smaller artery.
    There’s a 7 to 10 percent risk of significant bleeding during the leg procedure and that percentage goes up in obese patients. In the wrist catheterization, there’s virtually zero percent risk of bleeding, Dunker said.
    Dunker attended two separate courses, both in Canada, to learn how to perform the procedure, which is frequently used in Canada. French cardiologists started doing the procedure in 1996.
    Not many cardiologist in this area perform transradial because “it’s difficult to do,” Dunker said.
    The artery in the wrist is smaller than the femoral artery in the leg, meaning the catheters are different and the two arteries curve differently.
    Dunker performs several of the procedures each week at St. Mary’s, although he did not say exactly how many. The number of people who will be getting the procedure through the wrist will only increase in the next several years.
    In fact, a study showed that 80 percent of patients who have had both wrist and leg catheterization prefer having it done through the wrist.
    Page 2 of 2 - A patient must lie on their back for up to eight hours after the leg procedure to prevent the risk of bleeding. If someone has a back condition or pain, that can seem like an eternity.
    In transradial, the patient can sit up right after surgery and walk around, Dunker said.
    That also means hospital stays are shorter.
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