Background The radial approach has been increasingly used as an alternative to femoral access. And more procedures of repeated transradial coronary intervention (r-TRI) are performed. Few data about r-TRI has been obtained. Therefore, we tried to investigate the safety and feasibility of repeated transradial coronary intervention (r-TRI) in the same route.

Methods A total of 423 consecutive eligible patients undergoing repeated TRI were enrolled in r-TRI group, and 846 patients with initial TRI were assigned to i-TRI group in a 2- to-1 ratio matched by ages and gender. The primary endpoint included the success rate of procedure and incidence of vascular related complications.

Results The baseline clinical characteristics in two groups were comparable. The success rate of procedure in r-TRI and i-TRI was similar (96.0% vs 97.5%, p=0.130). In subgroup analysis (coronary angiography only or angiography with percutaneous coronary intervention), the similar result was also observed. The puncture numbers and incidence of radial artery spasm in r-TRI group were significant higher than i-TRI group (p=0.034 and p<0.001, respectively). The other procedural outcomes in two groups were identical. With respect to the incidence of overall vascular related complication and independent event, there were no significant difference in spite of higher incidence in r-TRI group (1.2% vs 0.7%, p=0.521). The patients in i-TRI group had more comfortable feeling than r-TRI group (p<0.001).

Conclusions Repeated TRI produces an equal success rate and a lower vascular complication when compared to initial TRI. It should be considered as an acceptable and safe procedure.