Radial Percutaneous Coronary Intervention in Complex Arm and Chest Vasculature: Tips and Tricks

  • Devang S. Parikh
  • Kejal Gandhi
  • Adhir ShroffEmail author
Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Coronary Artery Disease


Purpose of review

The purpose of this review is to identify the anatomical difficulties an operator may encounter during the transradial approach for cardiac catheterization and to offer tips and tricks to overcome those challenges.

Recent findings

With increasing implementation of the transradial approach for cardiac catheterization, many new techniques have been utilized to overcome anatomical challenges. This article also discusses the difficulties faced during transradial approach in patients with prior coronary artery bypass grafting (CABG).


Numerous large randomized trials have demonstrated the value of the transradial approach over the transfemoral approach during cardiac catheterization. However, this technique is routinely avoided or aborted due to anatomical variations in the upper arm and chest. These obstacles have delayed adoption of transradial access by operators despite the apparent benefits. This article reviews some of the available tips and tricks described in the literature to overcome anatomical obstacles. By implementing some of these tools into practice, an operator may realize improved procedural success, decreased procedure time, and improved patient comfort with the transradial approach.


Transradial approach Cardiac catheterization Coronary artery bypass grafting Radial percutaneous coronary intervention 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of Illinois – ChicagoChicagoUSA
  2. 2.B.J. Medical College, AhmedabadAhmedabadIndia

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