What Is Angiography (Angio)? Should It Be Done From the Wrist or the Groin?

Coronary angiography is the most fundamental diagnostic method with which we map the heart’s own arteries; it is used both for diagnosis and, when needed, for treatment (stenting). In this article I will explain how angiography is performed and why the choice of access site (wrist or groin) matters.

How Is Coronary Angiography Performed?

During the procedure we place a thin catheter into the arterial system and advance it as far as the heart’s own arteries; the contrast agent delivered from there allows us to map the inside of the vessels on X-ray images. In this way we clearly see the location, length and severity of a narrowing or blockage.

Angiography From the Wrist (Radial) vs. Angiography From the Groin (Femoral)

Traditionally the artery in the groin (femoral) was used; today the radial artery at the wrist is increasingly preferred. A large randomised trial (RIVAL) showed that access-site bleeding and vascular complications are markedly less frequent with procedures performed from the wrist than from the groin; for this reason we consider wrist access the first choice in suitable patients. Groin access, on the other hand, may be preferred when the wrist artery is not suitable or in certain special procedures that require larger equipment.

What to Watch Out for After Angiography

After a procedure performed from the wrist, pressure is applied with a short-term wristband/bandage, and the patient can usually walk home within a few hours. After procedures performed from the groin, lying flat for a few hours and limiting leg movement may be necessary. With both methods, if sudden swelling, bruising or bleeding is noticed at the access site, we recommend contacting us without delay.

Frequently Asked Questions

Is angiography a painful procedure? Apart from the local anaesthetic injection felt at the access site, there is no significant pain during the procedure.

Is the wrist or the groin safer? In general, the risk of bleeding and vascular complications is lower with wrist access; however, the decision may vary from patient to patient depending on the vascular anatomy.

When can I return to daily life after angiography? With procedures performed from the wrist most patients can return to daily life the same day, and with those performed from the groin usually the next day.

Conclusion

Angiography is the gold standard method in the diagnosis of coronary artery disease; the choice of access site is personalised according to the patient’s vascular anatomy and the nature of the procedure, but whenever possible we prefer access from the wrist.

You can book an appointment for a detailed examination to assess whether angiography is needed.

References

1. Jolly SS, Yusuf S, Cairns J, et al. Radial versus Femoral Access for Coronary Angiography and Intervention in Patients with Acute Coronary Syndromes (RIVAL): A Randomised, Parallel Group, Multicentre Trial. Lancet. 2011;377(9775):1409-1420.