Transradial access has become the standard vascular access for coronary interventions because it has been shown to reduce major bleeding, adverse cardiac events, and mortality compared to transfemoral access. Yet radial artery occlusion (RAO) remains a complication that, although mostly asymptomatic and clinically insignificant, can result in critical hand ischemia. In addition, RAO has historically been considered a formal contraindication to transradial coronary interventions. However, reopening a vascular access that was thought to be occluded provides a significant advantage to the operator. In this chapter, the authors detail the steps for reopening the occluded segment by antegrade and retrograde recanalization, with an emphasis on the use of DRA. The benefits, complications, and patency rates following retrograde RAO recanalization are also discussed, providing insights into this valuable approach to maintaining radial access for future procedures.