Vascular intervention has become an important diagnostic and treatment method, but the choice of pathways is still being optimized. The femoral artery is thick and straight, but has the potential for prolonged bed rest and serious complications; the brachial artery is prone to bleeding and occurrence of osteo-fascial syndrome is often not preferred; the radial artery is gradually becoming preferred because of easy hemostasis, no need for bed rest and few complications, and has been expanded from coronary artery to peripheral artery field. Since the beginning of radial artery pathway coronary angiography in 1989, the indications for coronary intervention have evolved to the treatment of unprotected left main lesions (UPLMT), bifurcation lesions, chronic occlusive lesions (CTO), acute myocardial infarction (AMI), elderly patients, etc. Cheng et al. and Hsueh et al. found no difference in the efficacy of radial and femoral artery pathways for UPLMT. Both the TEMPURA study and the Hou study in Chinese patients found comparable results between radial and femoral approaches for AMI, but the radial approach needs to be performed in centers with extensive interventional experience. With the improvement of interventional devices and operating techniques, complex operations for complex lesions can be performed through the radial artery, and Mamas et al. successfully completed 16 complex lesions using a 7.5F sheathless guiding catheter; Chengwandu used the TDP technique and obtained the same results as the femoral pathway for PCI of bifurcation lesions, but with fewer complications and better feasibility and safety. found that radial and femoral artery pathways had similar results for CTO lesions, and that bilateral radial artery pathway left and right coronary angiography could easily determine whether the guidewire was in the true lumen of the vessel. However, Hu Fenghuan et al. found that the complications of transradial pathway (especially age-related complications) were not higher in elderly patients than in younger age groups. Since the transradial intervention was carried out in our department in 2006, we have explored the above lesions and achieved similar results. It was also found that: the operator should be clear about the performance and diameter of the instruments used and the compatibility of the guiding catheter, careful operation, more fluoroscopy to reduce blind movements, and on-stage guidance for the skilled can significantly reduce complications. 1, the status and experience of radial artery pathway peripheral vascular intervention The radial artery pathway peripheral vascular intervention has flourished: whole brain angiography and renal arteriography have become common methods; Patel successfully performed vertebral artery stenting; Pinter internal carotid artery stenting success rate of 90%; Shiraishi completed renal artery stenting, Trani C more that the renal artery Trani C concluded that the opening direction and small diameter of the renal artery are more favorable for stenting via the radial artery pathway. We currently completed 14 cases of simultaneous stenting of coronary and vertebral and internal carotid artery stenosis/renal artery via radial artery, and found a high success rate. In the study, it was found that: vessel alignment and angulation should be clarified during imaging to guide catheter selection; most patients’ radial artery can tolerate 6-8F arterial sheath; nitroglycerin + nufacaine is beneficial to reduce radial artery spasm. 2. In practice, the indications are expanding. The special hydrophilic coated sheath for radial artery greatly reduces radial artery spasm; Asahi sheathless guiding catheter system reduces radial artery injury but increases the inner diameter of the catheter, making it possible to pass complex operations (such as rotary grinding) and large diameter stents (internal carotid artery stent); we can complete multi-site vascular (coronary artery, cerebral vascular, renal artery) imaging simultaneously with multi-functional contrast tubes, reducing the risk of arterial spasm. We can use multi-functional contrast tubes to complete multi-site angiography (coronary arteries, cerebral vessels, renal arteries, etc.) simultaneously, which reduces costs, complications and time; the pathways are diversified, with bilateral radial arteries and ulnar and brachial arteries becoming routine accesses; tortuous vessels and long-distance vascular lesions still require effective devices. There are very few reports of peripheral arterial disease and liver interventions via the radial artery, so the indications are yet to be developed. With the improvement of devices, refinement and refinement of techniques, and the in-depth development of large clinical studies, the scope of radial artery access will continue to expand, thus benefiting more and more patients.