Radial Artery Access, Hemostasis, and Radial Artery Occlusion

Radial artery access is usually achieved using a micropuncture system. Hydrophilic introducers are used to improve comfort, probably by reducing spasm. A vasodilator cocktail should be administered to prevent severe spasm and anticoagulation; usually, unfractionated heparin is administered to prevent subsequent radial artery occlusion (RAO). Hemostasis at the radial artery puncture site is easily achievable by local compression. Application of local compression frequently leads to interruption of radial artery flow and subsequent occlusion. Careful attention to maintenance of radial artery patency during hemostatic compression has been shown to decrease the risk of RAO without increasing access-related bleeding complications.