Crossover from radial to femoral access during a challenging percutaneous coronary intervention can make the difference between success and failure

Compared to femoral access, radial access carries lower bleeding risk during diagnostic coronary angiography and percutaneous coronary intervention (PCI). Although, in experienced centers, PCI success rates are reported to be similar using radial or femoral access, radial PCI may be technically challenging due to poor catheter support. We report a case of radial PCI in a saphenous vein graft (SVG) lesion that failed, in spite of using multiple guide catheters and prolonged fluoroscopy time. After obtaining femoral access, PCI of the SVG lesion was easily accomplished. For selected PCI cases, early switching from radial to femoral access may be the optimum strategy.