Rapid technological advances in interventional cardiology have led to a marked change in practice over the past 20 years. Improvements in balloon dilation and stent catheter design, coupled with advances in guide catheter technology, have allowed routine percutaneous coronary interventions (PCI) to be performed through smaller guides. Initially there was a change from 10 to 9 French (F) catheters, and more recently from 8 to 6 F. These developments have not only led to a reduction in arterial complications, but also to changes in arterial access sites. The radial route has become increasingly popular, virtually eliminating access site complications. Moreover, this route has been shown to be preferred by many patients, the prime advantages being patient comfort, early mobilisation and reduced bleeding complications.