Radial approach was introduced as a route for coronary angiography or interventions. We assessed clinical applicability at a high-volume laboratory and safety.

Procedure-related results were compared between phase I period including learning curve and phase II period in 326 patients, in whom coronary angiography or interventions were performed by radial approach.

1) Success rate was 90% (292/326) in all patients, which significantly increased to 95% (246/259) during phase II compared to 69% (46/67) during phase I. 2) Time from local anesthesia to sheath placement and time for first coronary cannulation were 4.3±2.7 min, 3.1±1.9 min, respectively, in all patients, which significantly decreased to 3.8±3.6 min, 2.7±2.4 min during phase II compared to 7.0±3.2 min, 5.7±4.7 min during phase I. Total examination time was 21.7±5.5 min in all patients, which significantly decreased to 20.4±6.2 min during phase II compared to 28.3±8.0 min during phase I. 3) Overall procedural success rate of coronary interventions was 94% (98/104). Guidewire didn't pass in 5 (5%) patients with chronic total occlusion and stent wasn't delivered in 1 (1%) due to poor guiding backup. 4) During follow-up of 61±25 days, weak or absent radial pulse, abnormal reverse Allen test were observed in 13 (5%), 3 (1%), 15 (6%) patients, respectively, but no claudication observed.

Coronary angiography and interventions by radial approach was safe and performed without more time delay after learning curve.