Since its introduction, the transradial access for percutaneous cardiovascular procedures has been associated with several advantages as compared to transfemoral approach, and has become the default for coronary angiography and intervention. In the last 30 years, a robust amount of evidence on the transradial approach has been mounted, promoting its diffusion worldwide. This article provides a comprehensive review of radial artery access for percutaneous cardiovascular interventions, including the evidence from clinical trials of transradial vs. transfemoral approach, technical considerations, access-site complications and limitations, alternative forearm accesses (e.g., ulnar and distal radial artery), and ultimately the use of the radial approach for structural interventions.

Coronary bifurcation lesions are considered among the most challenging lesions to treat with percutaneous coronary intervention (PCI), particularly in cases of extensively diseased branches. In the event of failure of a provisional (one-stent) approach, many two-stent bifurcation techniques can be performed for the treatment of coronary bifurcation lesions. Two techniques (culotte and T/TAP) are suggested by the European Bifurcation Club, but a reverse crush is performed by some operators. This study aims to retrospectively compare these two different approaches (EBC-recommended techniques vs. reverse crush).