A recipe to allay fears of cardiac patients keeping away from hospitals for fear of COVID

By Dr. Sanjeev Saxena in Cardiology

Sep 18, 2020

A Safer Path for Cardiac Patients During COVID Times: Why Radial Angioplasty Makes Sense

As the COVID-19 pandemic continues to reshape the world, its impact on healthcare behavior has been profound. Many cardiac patients, fearing exposure to the virus, are avoiding hospitals—even at the risk of worsening heart conditions or life-threatening complications. This avoidance, though understandable, can be dangerous.

To address these concerns, it’s essential to spotlight treatment options that not only provide effective care but also reduce the risk of COVID-19 exposure. Among these, minimally invasive cardiac procedures, particularly radial angiography and angioplasty, stand out as safe, efficient, and patient-friendly alternatives.

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Why Fear Is Keeping Patients Away

During the pandemic, the fear of hospital-acquired COVID-19 infection has led many patients to delay or forgo necessary cardiac interventions. However, avoiding treatment can lead to the progression of disease, heart failure, or even sudden cardiac events. The key lies in adopting procedures that reduce hospital stay, require minimal interaction with healthcare staff, and still deliver excellent outcomes.

The Role of Minimally Invasive Techniques

Minimally invasive heart procedures like angioplasty (to open blocked heart arteries) and angiography (to detect blockages) are increasingly preferred. Techniques that allow for shorter hospital stays and minimal staff contact are naturally safer in pandemic times.

While robotic procedures have made headlines—such as a robotic angioplasty performed remotely in Gujarat—their current application is experimental, costly, and not feasible on a large scale. More practical and widely available alternatives must be considered.

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Radial vs. Femoral Access: Understanding the Difference

There are two primary access points to reach the heart for angiography or angioplasty:

• Radial access (through the wrist or back of the hand)
• Femoral access (through the groin)

Globally, radial access has gained popularity for its many advantages—especially relevant during the pandemic.

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Advantages of Radial Access in COVID Times

1. Shorter Hospital Stay: Patients can often be discharged within a few hours after a radial angiogram and within 12–48 hours after angioplasty.
2. Less Staff-Patient Contact: Radial procedures allow patients to sit up, eat, and be mobile soon after the procedure. This limits the need for ICU or ward admission, where contact and infection risk are higher.
3. Lower Risk of Complications: Radial access has significantly fewer bleeding complications and a lower mortality rate compared to femoral access, especially in heart attack patients.
4. Safe Recovery Environment: After the procedure, patients can rest in a well-ventilated lounge while being monitored, maintaining social distancing norms.
5. Economic and Efficient: Radial angioplasty reduces costs by avoiding prolonged hospital stays and complications.

In contrast, femoral access typically requires the patient to lie flat for several hours, often in congested ICUs or wards. The risk of bleeding, need for manual compression, and potential for serious complications like pseudo-aneurysms all increase hospital stay, cost, and contact time—raising the risk of cross-infection.

Complications with Femoral Access

• Major bleeding requiring blood transfusions or surgery
• Formation of pseudo-aneurysms needing extended monitoring
• Higher likelihood of COVID exposure due to longer hospital stays and more interaction with healthcare workers

These risks are rarely seen with radial procedures.

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Why Isn’t Radial the Norm Yet?

Despite its advantages, radial angioplasty is underutilized in India. Only 30–40% of routine angioplasties and a mere 2% of heart attack-related angioplasties are done via the wrist. In the Delhi NCR region (Delhi, Noida, Gurgaon, Ghaziabad), the adoption rate remains low compared to southern India.

Barriers include:

• Limited training and experience among cardiologists
• Resistance to change due to the learning curve
• Lack of awareness among patients

The Way Forward

COVID-19 has underlined the urgent need for safer and more efficient healthcare delivery. Radial angiography and angioplasty offer a practical, proven solution that protects patients and healthcare workers alike—while delivering optimal cardiac care.

Also Read: Heart Patients Should Not Delay Hospital Visits Due To Covid-19 Fears

Conclusion

While robotic heart procedures may be the future, they’re not yet feasible for widespread use. In contrast, radial angiography and angioplasty are established, cost-effective, and reduce hospital exposure—making them especially suitable during COVID-19.

In summary:

• Radial access minimizes complications and contact
• Reduces cost and hospital stay
• Improves outcomes for cardiac patients
• Helps keep both patients and staff safer during the pandemic

It’s time for both doctors and patients to embrace this life-saving approach—not just during COVID, but beyond.