Radial artery occlusion: preventing insult to injury.

Intra-arterial nitroglycerin prior to transradial sheath removal may reduce the incidence of radial artery occlusion (RAO). Operators must observe careful attention to all aspects of transradial catheterization, particularly patent hemostasis; as well as independently monitor the institutional incidence of RAO to prompt improvements in practice. Future studies on the impact of pre-puncture ultrasound, novel sheaths, hemostatic devices, and potent oral and intravenous antithrombotic therapy on 30-day RAO diagnosed by ultrasound may allow further reduction of RAO in a real-world practice.