Despite the rapid conversion from routine femoral to radial access around the globe, there remain certain nagging concerns with this transition. The technical challenges have been met for most routine interventional procedures, but there are ongoing apprehensions about the effect on the radial artery from use as an access site. Radial artery occlusion (RAO) does occur [ ]. Still, while not generally as life-threatening as a femoral artery accident, RAO may make that artery unsuitable in the future for use further interventional use, in addition to a potential dialysis fistula or a cardiac bypass conduit. In the short run, patients with the end-stage renal disease do better with a transradial approach vs. femoral [ , ], but in the long run, it is uncertain if transradial procedures would materially interfere with the management of dialysis access in the renal population. In a similar vein, there has been fear that a previously used radial might not make a suitable bypass surgery conduit, an issue that has been spotlighted by the recent guidelines placing this conduit as the second choice after the internal thoracic graft [ ]. Similar to the issue involving renal patients, the ultimate effect of prior use in a radial graft remains speculative with little hard data [ ].