In a well-structured and contemporary metanalysis Isath et al. analyze the wealth of data comparing distal radial access (DRA) and conventional radial access (CRA)[ ]. This meta-analysis included 10 randomized controlled trials (RCTs, n = 5488) and 23 observational studies (OS, n = 6796). Radial artery occlusion (RAO) occurred in 1.7 % and 5.1 % in the DRA and CRA cohorts respectively (RR = 0.38, 95 % CI 0.27, 0.52, p -value of 0.007). RAO was consistent among both RCTs and OS without alarming signals of study heterogeneity. Access failure occurred more frequently among the DRA arm (OR 2.38, 95 % CI 1.46, 3.87) and was more pronounced in the RCT strata (OR 2.58, 95 % CI 1.40, 4.76). There was no difference in the rate of bleeding and hematomas between the study arms.