The first thumb angiography in the region was performed at SANKO University Hospital. Prof. Dr. Mustafa Çetin said, “The ‘thumb angio’ (snuff box-snuff box) procedure, which we performed in our hospital for the first time in the region, is a great comfort for both the patient and the doctor, as it holds the patient’s arm in a more comfortable position. The thumb angio approach has many medical advantages, ”he said.
THERE ARE MANY ADVANTAGES
Listing the advantages of the method, Prof. Dr. Çetin said the following:
“During angiography, blood flow to the hand continues through the superficial branch of the radial artery. Rigid structures just below the access area, such as the carpal bones, facilitate the pressure on the vein at the end of the procedure and the bleeding stops faster. Since there is no need to press around the wrist to stop the blood after the procedure, it allows the wrist to move freely after the procedure, which reduces venous (vein) occlusion of the hand and prevents the discomfort caused by swelling in the hand. In case of vasospasm (vasoconstriction) and hematoma that may occur in the vein during the intervention, the operator can easily switch to the traditional radial approach. For patients with chronic kidney disease, possible injury to the vein in the vascular conventional radial approach causes this site not to be used for hemodialysis. Thus, the snuff-box approach preserves the vessel for future arterio-venous fistula needs. The snuff box approach further protects the radial vessel and allows it to be used as a backup vessel in potential coronary artery bypass surgery candidates.
It takes 15 minutes
Providing information about coronary angiography, Prof. Dr. Çetin said, “It is the imaging of the heart vessels, or in other words, the x-ray of the vessels that feed the heart. Angiography is performed under local anesthesia, during angiography, the patient is awake and does not feel pain. “This process takes about 15 minutes,” he said.
Pointing out that coronary angiography can be performed by entering the groin vein (femoral artery) or wrist (radial artery) in order to view the heart vessels. Dr. Çetin shared the following information:
“Local anesthesia is applied to the venipuncture site and a sheath is placed into the vein, this procedure may be slightly painful. Subsequent procedures are painless. With the catheter (thin plastic tube 1.5 – 2 mm.) Entered through the vein sheath, the veins that feed the heart are reached. By injecting opaque material (dye) to the coronary vessels through the catheter, the film of the coronary vessels is taken. “
Explaining that the angiography from the inguinal vein (femoral artery) requires staying in bed for at least 4-6 hours after the procedure and the vascular problems are more than the arm, Prof. Dr. Çetin said, “However, it is an advantage that the groin vessel is larger in order to perform some complex balloon-stent procedures.”
Reminding that the angiography in the arm is performed by entering the wrist vein, Prof. Dr. Çetin continued as follows:
“Arm angiography is superior to groin angio in terms of patient comfort. After arm angiography, the patient can stand up immediately. The probability of angio-related problems in the wrist vein is much lower. Apart from this, the thumb (snuff box-snuff box) approach, which has been defined very recently and has become increasingly popular, and which we apply in our hospital, has many advantages over traditional radial (arm) access. In this approach, since the patient holds his arm in a more comfortable position, the procedure is more comfortable for both the patient and the operator. “
WHICH METHOD SHOULD BE PREFERRED?
Underlining that which of these methods will be better for the patient depends on the procedure to be performed, Prof. Dr. Çetin said, “Before angiography, the doctor and the patient should decide together whether it will be done in the groin or in the arm, depending on the patient’s condition and the procedure to be performed.”