Introduction: Transradial approach (TRA) is preferred vascular access site for coronary angiography resulting in lower 30-day mortality, major bleeding and access site complications when compared with transfemoral access. Radial artery occlusion (RAO) is the most common complication of TRA with an incidence of 0.8-10% (1). In most cases RAO is asymptomatic, but some patients feel pain at the site of occlusion, have paresthesia, and very rarely signs of acute ischemia of the arm (2).

Methods and Results: We analyzed 40 subjects who underwent diagnostic coronary angiography using TRA in a period of one month. All patients received 5000 IU of heparin and 200mcg of nitroglycerin after sheath insertion. After intervention hemostasis was performed with Terumo TR Band radial compression device according to standardized protocol. Three patients (8%) reported pain and paresthesia and we confirmed radial artery occlusion using doppler imaging. One patient was hospitalized because of severe pain but without signs of critical ischemia. The patient was treated with aspirin and enoxaparin by subcutaneous injection for 5 days, following with rivaroxaban 20mg for 3 weeks and completely recovered.

Conclusion: Radial artery occlusion is the most common complication of TRA, but with a low clinical significance. Patency of radial artery is important for future coronary artery procedures, coronary artery bypass grafting, arteriovenous fistula formation or intra-arterial pressure monitoring. Proper medication application together with patent hemostasis reduce the risk of RAO (3).