The radial artery has currently been regarded as a useful vascular access site for coronary procedures. We want to evaluate the incidence and clinical significance of anomalous branching pattern and tortuosity of radial artery.

From May 1997 to May 1999, retrograde radial artery angiography was performed in 1191 cases. Branching anomaly and tortuosity of upper extremity artery, procedure times and local vascular complications were analyzed.

1) Anomalous radial arterial branching was found in 3.2%. Most common one was high origin of the radial artery (2.4%). 2) Tortuosity of radial artery was found in 4.2%. Most common tortuosity were S shape in 1.8% and omega shape in 1.8% of cases. 3) Cross over to other artery, radial artery occlusion and perforation occurred in 24 cases, 6 cases and 4 cases, respectively. Prolonged procedure times, crossover to other artery and radial artery perforation was related with tortuosity of radial artery, not with anomalous branching.

The incidence in bran-ching anomaly and tortuosity of radial artery was not frequent in our study. Radial artery tortuosity was associated with old age, prolonged procedure time and radial artery perforation. In selected cases, pre- or intra-procedural angiographic assessment of radial artery might be helpful in performing safe procedure.