We read with great interest the article by Colombo in CRM volume 44 November 22 page 21–9 . We agree that the radial approach for PCI has become the standard for diagnostic and interventional coronary procedures . As we have moved from hospital to outpatient centers for most diagnostic and PCI procedures, the radial approach is shown to reduce bleeding and it is ideal in an outpatient facility. Our center became Radial first 13 years ago; however, with our experience with the radial approach in carotid diagnostic and interventional procedures, we found the easy ability to image the left internal mammary artery via the right wrist also. As Colombo states the radial approach has proven to be not only effective, but safe and reduce complications including morbidity and mortality.