Trans-Radial Coronary Interventions Using A Sheathless Guiding Catheter

Inclusion criteria: * Patients need to be at least 18 years old. * Patients presenting with a significant coronary artery disease who qualify for PCI and who can be treated by a radial approach. * Any women requiring PCI who can be treated by a radial approach. * Any patients with a bifurcation lesion or the ostial lesion of the left anterior descending (LAD) and/or left circumflex artery (LCX), lesions commonly treated with a 7 Fr guiding catheter. * Bifurcation lesion = any lesion of a main epicardial vessel (i.e. LAD, LCX, right coronary artery) involving at least one major side branch (i.e. diagonal or marginal branches). * Ostial lesion of the LAD or LCX = presence of a significant stenosis \<5mm from the distal part of the left main. Exclusion Criteria: * Patients who refused to give their written informed consent. * Male patients, in whom PCI can be easily performed with a 6 Fr standard guiding catheter (i.e. no bifurcation or ostial lesion). * Patients in whom the radial approach is contra-indicated: * Patients with a dialysis arteria-venous fistula or in whom an arteria-venous fistula is planed in the future. * Patients with a known radial artery occlusion. * Patients in whom a radial approach was unsuccessfully already attempted in the past (anamnestic notion or previous medical record) secondary to a: * Challenging vessel anatomy, * Vessel tortuosity, * Known impossibility to cannulate the coronary ostia by the radial approach. * Patients in whom the Allen test results pathological bilaterally: * In case of pathological Allen test in one hand the other hand will be tested before choosing the femoral approach. * Patients in whom the femoral approach is adopted as primary catheterization approach (at interventionist's discretion), including: * Unstable patients (myocardial infarction, cardiogenic shock). * Patients necessitating femoral access for an intra-aortic balloon counterpulsation * Patients presenting with a double mammary coronary graft (right and left internal mammary utilized for by-pass grafts). * Coronary interventions where an extreme good guiding support is mandatory (i.e. PCI of chronic total occlusion, PCI with Rotablator). * Particularly risky PCI (e.g., PCI of the left main artery), where the femoral approach may be more comfortable for the operator. * Patients requiring a femoral approach for a right heart catheterization.