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September 2021 Br J Cardiol 2021;28:109–11 doi:10.5837/bjc.2021.039

Heparin-free distal radial artery approach to cardiac catheterisation and the small radial recurrent artery

Pitt O Lim, Ziyad Elghamry

Abstract

Introduction Giving heparin with radial artery access cardiac catheterisation is standard practice to prevent radial artery occlusion (RAO).1,2 However, this is complicated by access-site bleeding in nearly one quarter of cases,2,3 and more significant forearm haematoma approaching a 10% incidence with the 6Fr catheter system.4 The ‘newer’ distal radial artery (dRA) approach, where the radial artery is punctured in the anatomical ‘snuff box’, i.e. beyond the radial artery bifurcation into the palmar arch branches, has significantly less RAO.5 Hence, we have defaulted to the dRA approach in our allcomers’ cardiac catheterisation prac

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