Radial approach to right heart catheterization and intervention

Transradial cardiac procedures have many advantages over the femoral approach, but forgotten is a similarly eloquent approach to venous access. Central venous access can actually be easily obtained using the forearm veins without risking the femoral or neck approaches. Whether it is needed for right heart hemodynamic monitoring or diagnosis with a cardiac catheter, as a site for temporary pacing during periods of iatrogenic bradycardia from interventional techniques, or as a site for a transvenous interventional procedure, forearm venous access can provide a reliable and safe entry site to compliment or complete the transradial procedure. Venous access from the forearm can be accomplished efficiently and without compromise by avoiding an otherwise riskier anatomical approach. Understanding venous techniques and recognizing this important adjunct to transradial interventions completes the operator's radial skills and further enhance the potential of transradial interventions.