Abstract
One of the challenges of the radial approach is radial artery spasm. Because of the smaller caliber, the guide catheters can cause significant spasm that can complicate the procedure or even preclude it. One of the most effective ways to avoid radial artery spasm and stuck catheters is to employ the use of a protective sheath. Recently special long radial sheaths have been developed that completely cover the radial artery, thus precluding the possibility of spasm. In addition, the protection results in less trauma to the innovation of long radial sheaths has dramatically decreased the issues surrounding radial artery spasm. The nuances of the long radial sheaths and a protocol for their use are described.