When femoral artery is used instead of radial artery for coronary angiography? Leading coronary artery minimally invasive intervention cardiologist explains. Coronary artery angiography is used to assess patients prior to coronary artery bypass grafting surgery. Dr. Jeffrey Popma, MD. Coronary artery angiogram is also used before percutaneous coronary artery procedures. Dr. Anton Titov, MD. Sometimes patients could benefit from a radial artery approach in coronary artery angiography. Is it preferred over the classical femoral approach? You are particularly interested in this. You are an international expert in the radial approach coronary artery angiography. Dr. Jeffrey Popma, MD. I have to say that all of our practitioners here at the Beth Israel Deaconess Hospital are "radialists". This probably happened about seven years ago or so. Then a couple of interventional cardiologists started to use the radial artery approach in coronary angiography. We found that the patients liked it better. Dr. Anton Titov, MD. They recovered quicker, patients were more active, the bleeding complications were less. Dr. Jeffrey Popma, MD. We became proficient in terms of gaining access to the coronaries and taking pictures. Today we are in the 80% to 90% range for radial artery access coronary angiography. With all our practitioners here, all the doctors here do that. For us it is allowed more rapid thrombus lysis. Dr. Anton Titov, MD. Radial artery coronary angiography allows the same-day discharge after percutaneous interventions. It is been much better. Dr. Jeffrey Popma, MD. But there are some patients that have very small radial arteries. Some radial arteries have tortuosity of the radial artery before it gets up to the shoulder. Or they have the access of the subclavian artery into the aorta. Which makes it very difficult to then engage and canulate the coronary arteries. Dr. Anton Titov, MD. It is a rare patient, one in ten times or so. Rarely patients have unusual artery anatomy. Then we would use the femoral artery approach in those patients. This is how we do coronary artery angiography.