Facilitating radial conversion.

I was trained with femoral catheterization techniques and found catheterization from the right radial artery to be a frustrating experience. Specialized catheters were of no avail in reducing excessive fluoroscopic time or providing the guide catheter support that I was accustomed to from the femoral approach. I nearly abandoned the radial technique. I then chose to cannulate the left radial artery from the left side of the patient with the hole in the drape typically reserved for left femoral access. As a right-handed operator, I position myself between the patient and his abducted left arm. After obtaining radial access, we remove the left arm from the arm board and slide the left wrist and drape together, placing the pronated left arm comfortably over the left femoral region. I return to the right side of the patient and proceed with cardiac catheterization from the left radial artery as I would from the left femoral artery, with 1 minor difference: I begin with a Judkin’s curve that is a one-half-size less than I would typically use from the femoral approach. I was surprised to learn from the excellent summary of current transradial practice by Bertrand et al. (1) that “the arge majority (89.4%) of operators use the right radial artery as he initial side.” Perhaps, this simple technique might lead thers comfortable with the femoral approach to consider a much less emanding transition to using the radial artery for cardiac catheterzation and intervention. Potential advantages of the radial technique nclude comfort, safety, and early discharge, including outpatient ngioplasty for uncomplicated procedures.