?When the chest pain began one Friday afternoon, Randy Floyd of Lake Mary called his doctor, knowing what might lie ahead. With a history of coronary disease, he knew the warning signs. So when the physician assistant told him to head straight to the ER, Floyd recalled his two previous cardiac catheterizations, which opened his blocked arteries, and dreaded what was to come.

When he arrived at the Central Florida Regional Hospital ER, his doctors concluded that he hadn't had a heart attack, but they still needed catheterization to diagnose and, if possible, treat the cause of his pain. The good news: Floyd's catheterization could be done by means of a technique known as the radial approach, which would minimize his discomfort and have him back to normal activities faster than before.

The radial approach isn't new: it's making a comeback because of new tools and advancements in the devices and medicines that are used. Radial catheterization can reduce the risks typically associated with the common femoral ap­proach. Best of all, there's much less discomfort and the patient can usually return to normal activities within a few days.

"Most patients requiring catheterization should be candidates for the radial approach," says Carlos Grullon, MD, an interventional cardiologist at Central Florida Regional Hospital. "By accessing the heart through the radial artery, we have better control of bleeding, and the patient can get up, walk, eat and move around soon after the procedure." Not only are they more comfortable, he says, but because they're up and walking sooner, there are fewer complications.

After traditional femoral catheterization, patients leave the cath lab with a sheath in the femoral artery. Because patients receive blood thinners before the procedure, they have to be monitored closely. That can mean a hospital stay with up to 10 hours or more of bed rest while applying direct pressure.

But after radial catheterization, direct pressure is applied by means of an inflated clear radial band, which also makes it easy to monitor bleeding. Pressure is gradually decreased until there's no bleeding, and eventually the band is replaced by a pressure bandage.

"The radial approach is good for a lot of reasons," says Grullon. "I suspect there will be a time very soon that the patient who has a cardiac intervention will go home the same day and not require a hospital stay."

For Randy Floyd, it meant going home the next day. And three days later he was back at work. "I like to be active. I like to be up and around," Floyd says. "Following my two previous catheterizations, I had to lie down or sit still for a week. This time I was back to my normal routine the day after."

Central Florida Regional Hospital
1401 W. Seminole Blvd., Sanford;407.302.7363; 800.445.3392 (physician referrals); centralfloridaregional.com.

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