Franciscan Health is proud to be among the first adopters for the distal radial artery cannulation at the anatomical snuff box technique, which is just now gaining momentum among interventional cardiologists across the U.S.
Faheem Ahmad, MD, is a board-certified interventional cardiologist who practices at Franciscan Health in Crown Point, Indiana and Chicago Heights and Olympia Fields, Illinois. He recently spoke with us about this new, patient-friendly approach to angiograms and angioplasties.
Q. What is a snuff box?
A. The so-called anatomical snuff box is the name for the depression in the area of the base of the thumb and where the first finger starts. As the name suggests, people used to snuff tobacco from this area of the hand.
Q. What is distal radial artery cannulation at the anatomical snuff box?
A. This refers to a process in which the interventional cardiologist gains access to the distal radial artery via the anatomical snuff box in order to perform endovascular procedures.
Q. What procedures can be performed using this new approach?
A. We have used this approach for diagnostic angiogram, angioplasties and stenting of the arteries. I have also used it to perform peripheral artery diagnostics.
More and more interventional cardiologists around the country are employing this approach for accessing arteries in the legs, spleen and liver in addition to uterine artery embolization. We can essentially do everything from this access point, including bypass, grafts, angioplasties and more.
Q. What are some commonly used approaches that this can replace?
A. For many years the point of access for angiograms was the groin area. Now, 48 percent of these procedures in the U.S. and 90 percent in Europe are performed by accessing the radial artery at the wrist area. This approach provides less risk of bleeding and the ability to sit up immediately following the procedure. Most recently, access at the snuff box allows the hand to be placed in a more natural, comfortable position and eliminates the need to splint the wrist after the procedure.
Q. How common is this new approach?
A. This is a very new procedure that was started in Holland. Franciscan Health is among the first hospitals in Illinois and Indiana to adopt this approach.
Q. What are some other advantages of distal radial artery cannulation at the anatomical snuff box?
A. Using this approach offers fewer bleeding complications, greater comfort for the patient and the surgeon, immediate post-procedure mobilization, and immediate use of the wrist. This access point helps avoid the chance of scar formation in patients who have had several procedures that used radial (wrist) artery access. It is also beneficial for both obese and very thin patients.