**1. Introduction**

Radial artery access for angiography was first described in 1948 via cut down and direct insertion into either right or left radial artery [1], and in 1989 direct coronary angiography with percutaneous access via left radial artery [2]. Since then, radial artery access has advanced catheterization for patients by reducing vascular site bleeding which translated into both lower mortality and lower costs [3, 4]. Lesser known advantages include opening up both femoral arteries for larger sheaths for both hemodynamic support, complex coronary, peripheral or structural cases, as well as patient satisfaction. Acceptance has been slow by operators given the artery is smaller, orthopedic concerns of the operator with left radial and navigating catheters thru tortuous vascular anatomy, resulting in longer cases and higher radiation exposure [5, 6]. Advances in both techniques and medical devices have overcome many of the concerns opening up the wrist arteries for a far greater number than the past, translating into benefits for patients, hospitals and physicians.
