Christopher Regan, MD, is an interventional cardiologist, a specialist who uses minimally invasive catheter-based procedures to treat coronary artery disease and peripheral vascular disease—the narrowing or blocking of the arteries usually caused by cholesterol and fatty deposits.
Dr. Regan says he chose his field when he was in training and seeing patients with severe chest pain. “There was an interventional cardiologist who would do his work, and within an hour the patient would be thanking him and shaking his hand,” he says.
Almost 20 years later, some cases still require open heart surgery, but catheterization is providing an easier alternative in more situations. “No incision is needed for these procedures. We go through the skin and just use needles and tubes to fix the problem,” Dr. Regan says. He inserts a flexible tube, or catheter, through the skin and into the artery to guide in a small balloon to push the artery open. Then, he places a tube called a stent to keep it open.
Catheterization itself is changing, says Dr. Regan, who is also a researcher investigating ways to improve the devices he uses. While the procedure traditionally involves inserting a catheter in through the femoral artery in the groin area, smaller, specially designed tubes are making it possible to start more procedures in the radial artery from the wrist area. “That’s a fantastic advance because the patient doesn’t have to lay flat for a four- to six-hour period to allow the artery in the leg to heal,” he says. “The risk of bleeding and damage to the artery is reduced because the artery is so small that you would see even a small amount of blood right away, and you can just put some pressure on it.”
He especially enjoys his work when he walks a patient through a procedure and watches as the patient starts to understand it. “It brings a lot of comfort to them, and I can see that,” he says. “They may still be nervous, but I can see the change in them in the office visit. Also, these are procedures that only require moderate sedation, so patients are awake enough that I can tell them what's going on during the procedure. Then, I go over everything with them afterwards. And that's very gratifying.”