The Clinton Herald, Clinton, Iowa

February 6, 2014

Cutting edge procedure

By Scott Levine Herald Associate Editor
The Clinton Herald

---- — Today is the second in a series of articles, published each Thursday, focusing on February's American Heart Month.

CLINTON Dr. Ali Albaghdadi wants patients to have a better tomorrow.

To help the recovery process along for individuals, Albaghdadi is utilizing a technique at Mercy Medical Center North that few hospitals in the United States are using.

The cardiologist is using a new method for cardiovascular catheterization procedures called radial artery access. According to information published in September by Wake Forest Baptist Health Center, approximately 10 percent of hospitals currently use that method.

The recovery time for patients is usually quicker, and normally less painful, using this technique, Albaghdadi said.

"The next day is going to be easier," Albaghdadi said. "The soreness factor is probably a lot higher in the groin than the wrist."

Cardiovascular catheterization is a commonly used procedure to detect blockages in blood vessels in the heart and throughout the body. The procedure is used to clear blockages using angioplasty and stents to restore blood flow.

The majority of these procedures is done using a a catheter inserted near the groin into the femoral artery at the top of the leg and threaded into the heart or peripheral arteries.

In the radial access method, the cardiologist enters through the radial artery in the wrist, instead of the femoral artery near the groin, as an entry point.

This creates a better recovery time for patients, but makes it more difficult for the doctor, Albaghdadi said.

"It's not a lot different," said Albaghdadi, explaining the differences between the two methods. "It's really all about patient satisfaction. It's a little harder for the doctor but a little easier for the patient."

The ease for the patient comes from recovery time and reduced chances of excessive bleeding. In best case scenarios where nothing needs to be repaired, the patient is given a cuff around his or her wrist after the surgery, and after two hours, the cuff is removed.

Mercy staff members then make sure the patient is OK before sending them home an hour later.

If Albaghdadi enters through the groin area, the patient must lay down a minimum of three hours, and cannot leave until after at least 4 1/2 hours. However, Albaghdadi said cases can force the patient to lay still for six to eight hours.

"Also, from a safety standpoint, people bleed more in the groin," Albaghdadi said.

The femoral artery is used often, in part, because of its large size, making it easier for doctors to maneuver balloons, stents and catheters through the body. However, the heavy pressure at the insertion site causes a higher risk for bleeding, including, in some cases, internal bleeding.

According to published medical articles, the femoral artery also can be difficult to access in obese individuals.

But not everyone can utilize the radial artery access method.

"We're not able to fix everything from the wrist," Albaghdadi said. "If I think I'll need other equipment or if the patient already has stents, then I'll likely go through the groin."

If a patient entered the emergency room for a heart attack, Albaghdadi said they would enter through the groin area on those patients, too.

Currently, Albaghdadi said about 40 percent of the cardiovascular catheterization procedures he performs are through the radial artery access method. Of those patients, about 10 percent of those cases need something fixed once Albaghdadi enters the body.

The number of procedures he performs using the radial artery is increasing, though.

"It takes practice," Albaghdadi said. "It's getting more common as more younger guys are getting trained. But it takes some time getting trained. It's not super easy. Experience helps you figure it out."

And Albaghdadi is getting more experienced. He said he typically performs the cardiovascular catheterization about five to 10 times a week, with a little less than half of those using the radial artery method.

One of the items helping the University of Iowa graduate throughout the increased usage of the new method is the equipment recently purchased by Mercy Medical Center in Clinton.

In 2011, the two cath labs began renovations to install advanced imaging and documentation. The Artis zee angiography system, developed by Siemens Medical Solutions, provides physicians with highly detailed images of a patient’s blood vessels during diagnostic and treatment procedures.

With advanced technology, three-dimensional images with high resolution allow physicians to see the finest blood vessels and interventional devices, such as guidewires and catheters, in precise detail from almost any angle.

"The equipment is amazing," Albaghdadi said.

With new technology updating almost every day, Albaghdadi is confident that Mercy will stay ahead in searching for the best ways to treat patients.

"We do really great stuff here," Albaghdadi said. "We have the people and the equipment that people would envy."