Key Points Radial artery occlusion is a function of anticoagulation, compression time, compression pressure, and vascular injury from sheath size and puncture attempts. This study showed that increased levels of anticoagulation during transradial cases is associated with a higher incidence of occlusive hemostasis, increasing the risk of radial artery occlusion. Reductions in compression time as made possible by adjunctive hemostatic patches may obviate the need for high doses of heparin.