Anatomical considerations in transradial intervention.

The radial artery is currently regarded as a useful vascular access site for coronary procedures. The transradial approach for percutaneous coronary procedures has the advantage of reduced access site complications but is associated with specific technical challenges in comparison with the transfemoral approach. Transradial procedure failures can sometimes be due to failure to puncture the artery, radial artery spasm and anatomic variations of radial-brachial-axillary-subclavian artery axis or arch of aorta. Therefore, adequate anatomical information of the radial artery should be helpful in performing the transradial coronary procedure. In short proper patient selection and pre-procedure preparation; gentle and patient approach; liberal use of dye injection (check shoots) when in doubt; asking patient to breathe deeply when needed and thoughtful problem solving approach are the key factors to achieve high transradial success rate.