Abstract
Transradial artery access (TRA) is associated with reduced bleeding risk, length of stay, costs, and increased patient satisfaction. Approximately one-third of TRA failures are due to lack of guiding catheter support. Catheter selection and engagement technique are crucial for obtaining good-quality angiograms and successfully completing percutaneous coronary intervention. The maneuvers required for catheter manipulation and coronary engagement differ between TRA and transfemoral arterial access. One of the advantages of TRA is the ability to use a universal catheter, saving time, radiation, and contrast. This review discusses practical learning points to improve operator understanding of catheter selection and coronary engagement technique.