1. The RAUST study compared ultrasound versus palpation guidance for transradial artery access and found that ultrasound guidance significantly improved first-pass success rates and reduced the number of access attempts and time to successful sheath insertion. 2. Ultrasound guidance also decreased the incidence of difficult access procedures defined as requiring 5 or more minutes or attempts. Ultrasound was an effective rescue technique for difficult palpation-guided access. 3. Clinical outcomes like radial artery spasm, vascular complications, and patient pain were similar between the ultrasound and palpation groups.