If your arteries are clogged and you're facing an angioplasty, your doctor may offer you an unusual choice: wrist or groin?

Though the number of doctors who perform wrist angioplasty remains small in the United States -- just 1.3 percent of the one million angioplasties performed yearly in the United States, according to one study -- the number is growing as practitioners tout its benefits: less pain, less bleeding and shorter hospital stays.

But surgeons who prefer to stick with the groin call the wrist procedure a ''gimmick'' that takes more time and can't be used in many critical heart procedures.

''Depending on whom you ask, it's the greatest thing since sliced bread or a pain in the neck,'' says University of Miami cardiologist Dr. Alan Heldman, who does both surgeries.

Wrist angioplasty has been around for 20 years, and is used in 40 percent of angioplasties in Europe and Japan, according to a 2008 Duke University study.

In doing angioplasty via the groin, the surgeon cuts into the femoral artery, which can be up to four-tenths of an inch in diameter. He runs the catheter up the artery to the heart, where he inflates a balloon at its end to push aside the plaque to open the artery and restore blood flow.

When the operation is over, the doctor closes the incision in the artery and applies special compression closure devices to it to stop bleeding. The patient must lie completely still for four to six hours to keep it from reopening, says Dr. Ramon Quesada, a cardiologist at Baptist Cardiac & Vascular Institute in Kendall.

With the wrist procedure, the surgeon accesses the radial artery -- which is only about a tenth of an inch in diameter. When the operation is over, he closes the incision and applies a small compression device that looks like a plastic wristwatch to stop the bleeding. The patient sits in a chair or lies in bed for about two hours, then can go home with just a small bandage over the incision.

''It's better for the patient,'' says Quesada, who says he has done thousands of wrist angioplasties over the past 10 years.

''He can go to a movie. He can go to the mall,'' Quesada says.

''Just don't go play tennis,'' says Dr. Juan-Carlos Londoño, who practices at Mount Sinai Hospital in Miami Beach. He has performed 100 wrist angioplasties in the past six months, he says.

''They decrease the risks of complications from bleeding,'' he says. ``They increase the patient's comfort. They decrease the recovery time.''

The cost of the two procedures is similar, and insurance companies pay for both, as neither is considered experimental anymore. Why aren't more doctors doing it?

MORE OF A GIMMICK

''The wrist is more of a gimmick than an advantage from my point of view,'' says Dr. Jose Marquez, a cardiac surgeon at Mercy Hospital in Miami who does all of his angioplasties through the groin.

In wrist angioplasty, he says, the tiny catheter pushed through the radial artery sometimes reaches the heart and cannot negotiate the curves that lead to the blocked artery.

``I've seen some guys doing the wrist procedure struggle for two hours just to get access.''

Dr. Howard Bush, a cardiologist at the Cleveland Clinic in Weston, also does angioplasty through the groin, not the wrist.

''The groin is more user-friendly to the doctor,'' he says. ``It takes less skill and less training to go in from the groin.''

The larger catheters used in groin angioplasty, unlike the tiny wrist catheters, can have curves built in at their tips to make it easier to negotiate the curves in the heart to reach the blocked artery, he says.

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