Transradial access in an occluded radial artery: new technique

Radial access is considered clearly impossible in patients who develop radial artery occlusion after a transradial procedure. Radial artery occlusion also prohibits an ipsilateral transulnar approach. For patient subsets such as those with dialysis access in the other upper extremity or an occluded left radial artery with left internal mammary artery bypass grafts, switching to the transfemoral approach becomes inevitable. In some instances, the femoral access is also not an option due to severe aortoiliac disease. We describe a technique that allows the operator to access the proximal circulation from the occluded radial artery.