Gentleman, rebel and believer: the radial way.

The manuscript highlights some historic milestones of the universal trans-radial approach (TRA) and describes some characteristics that "radialists" share (at least in the author's opinion). The author argues against common misconceptions about the TRA, like the use of more iodine contrast, more X-ray exposition, a lower rate of successful angioplasty. Data illustrating the conversion from a trans-femoral approach catheterization laboratory to a complete TRA laboratory are presented, showing the speed of the switch and the rapid clinical benefit observed. The author concludes with possible future directions for TRA supporters, on how to optimize the material for the puncture step, how to reduce the radial occlusion rate and how to promote the TRA as the first access for acute coronary syndromes managed invasively.