Introduction: Local vascular complications, hematomas or bleeding are the most common complications of invasive coronary interventions and are significantly lower if performed transradial than transfemoral. Neurological complications of invasive coronary procedures are very rare, and for now there is no evidence of their increased rate after radial access. (1)

Patients and Methods: We analyzed the differences in complications of coronary interventions between two 9-month periods in the catheterization laboratory in Slavonski Brod: January to September 2015, when 82% of the procedures were done transfemoral and from January to September 2016, when 87% of procedures were done transradial. The transition period between September 2015 and January 2016 was not included in the analysis.

Results: In specified period in 2015 there were 584 procedures, of which 18% transradial. There were 11 (1.88%) local vascular complications or bleeding, and 1 case (0.17%) of transient cerebral ischemic attack (TIA) after femoral approach. During the same period in 2016, there were 913 coronary procedures, of which 87% transradial. There were 4 (0.44%) local vascular complications or bleeding, all of which after femoral approach. There were 4 (0.44%), cerebrovascular incidents: two TIA and two ischemic strokes of which one with remaining deficit, and one with a fatal outcome. Common clinical features of patients with neurological complications were: female gender, age greater than 80 years, diabetes, known vascular disease, previous cerebrovascular incident, acute coronary syndrome, and right radial access.

Conclusion: Radial approach was proven to be safe and effective, with a significant reduction in the number of vascular complications and insignficant increase in the number of neurological complications, whose incidence remained below 0.5%. In the case of patients with associated three or more risk factors mentioned above, access site of choice should be left radial or alternatively femoral.