The radial approach in the cardiac catheterization laboratory: is it meant to become the gold standard?

The transradial approach in interventional cardiology was born twenty years ago. Since then, many studies and meta-analyses have compared it with the former approaches, the transfemoral in particular. The most recent data is reviewed in this article through a double perspective: an anatomical and technical viewpoint in terms of a practical and successful vascular access; and a clinical and economical viewpoint with actual data concerning access site bleeding, access site complications, with a particular emphasis on the radial approach. Its impact on major adverse events, cost-effectiveness and patient comfort are also discussed. New advances and techniques are emerging with the radial approach which is gaining more and more magnitude in the world of interventional cardiology. However, can we actually affirm that this approach is meant to become the gold standard?