In the past decade, the Transradial Approach (TRA) has constantly gained ground
among interventional cardiologists. TRA’s anatomical advantages, in addition to patients’ acceptance
and financial benefits, due to rapid patient mobilization and shorter hospital stay, made it the
default approach in most catheterization laboratories.
Access-site complications of TRA are rare and usually of little clinical impact, thus, they are often
overlooked and underdiagnosed. Radial Artery Occlusion (RAO) is the most common, followed by
radial artery spasm, perforation, hemorrhagic complications, pseudoaneurysm, arterio-venous fistula,
and even rarer complications, such as nerve injury, sterile granuloma, eversion endarterectomy
or skin necrosis. Most of them are conservatively treated, but rarely, surgical treatment may be
needed and late diagnosis may lead to life-threatening situations, such as hand ischemia or compartment
syndrome and tissue loss. Additionally, some complications may eventually lead to TRA failure
and switch to a different approach.
On the other hand, it is the opinion of the authors that non-occlusive radial artery injury, commonly
included in TRA’s complications in the literature, should be regarded more as an anticipated
functional and anatomical cascade, following radial artery puncture and sheath insertion.