 The transradial approach is increasingly used in percutaneous coronary intervention PCI because of lower major access site complications, lower bleeding risk and earlier patient mobilization. According to this trend, in the last couple of years at the University Hospital of Geneva the investigators have changed their practice and currently the transradial approach is the most frequently used for PCI. However, the small diameter of the radial artery remains a major limitation of the technique, especially in women or for complex PCI necessitating larger bore guiding catheters. This may be overcome with sheathless guiding catheters Asahi, Japan, allowing for a standard inner catheter diameter 6-7 Fr, with an outer diameter equivalent to a standard 5 and 6 Fr introducer sheath. 