From the initial reports of transradial catheterization almost 35 years ago [ ], a sea of clinical evidence has left little doubt that the radial artery should be the primary access site for diagnostic and interventional coronary procedures. Multiple studies have consistently demonstrated decreased access site complications and bleeding while also showing improved cost effectiveness and patient comfort, and some have even demonstrated benefit in cardiac and overall mortality [ ]. Accordingly, the radial artery is now the most common access site in many countries, including the United States [ ].