TR approach is suitable for most patients and limitation of this approach is very low. It became more popular and approved in international guidelines because of increase success rate and low complication rate and low cost. There is also parallel advancement in instruments used in TR approach. Method and Result: patients admitted for CA or PCI. Data collected from patient and procedure including age, sex, contrast volume, total procedure time. flouro time, radial artery spasm and number of

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... that transformed to femoral. We divided the study in two groups: group A first half of patient and group B the second half Total numbers of patients (139) and there age ranging from 28 to 80 years (mean of 55.13). Number of males 131 (94.2%) and females 8 (5.7%).The mean value of contrast volume used in group A that underwent CA, ad hoc and PCI ,(was 63.10,124.20 and 106.91 ml) respectively and for group B (50.07,88.19 and 49.56 ml).The mean total time of procedure of group A underwent CA, ad hoc and PCI was (17.16,24.9 and 26.13 minutes) respectively and for group B(13.66,26.3 and 16.4 minutes).The mean fluorotime of group A underwent CA, ad hoc and PCI was (4.61,7.2 and 6.62 minutes) and for group B (3.06,7.32 and 3.51 minutes ). Seventeen case subjected to radial artery spasms divided into 11 cases (15.7%) in group A and 6 cases (8.69 %) in group B. There were 8 cases (11.4 %) of group A transferred to femoral approach and 4 cases (5.79 %) of group B transferred to femoral access. Conclusion: There was much benefit from the effect of learning curve in doing TR approach to CA and PCI.