Radial catheterization pitfalls

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Potential Pitfalls of the Radial Approach to Cardiac Catheterization

1. Spasm
2. Vessel tortuosity
3. Guide catheter support and selection may be reduced
4. Loss of radial artery pulse in 4% of cases
5. Potential increase in the duration of the procedure and fluroscopy time
6. The radial artery has been instrumented should there be a desire to use it as a conduit for CABG
7. It is the second and not the first approach learned by trainees
8. There is a learning curve in treating spasm, navigating anatomy, and manipulating catheters
9. Anatomically there can be a loop in the artery near the brachial in about 10% of cases
10. Smaller sheaths are required (4-8F)