Abstract: Objective：To investigate the feasibility and safety of brachial artery or femoral artery approach in percutaneous coronary intervention (PCI) after the transradial artery approach fails. Methods： After failure in transradial artery approach in PCI， the patients were randomly divided into two groups： brachial artery approach (n=117) and femoral artery approach (n=115). The average puncture time， puncture success rate， X-ray exposure time， postoperative compression time and the incidence of bleeding time in the puncture site， pseudoaneurysm， and vagal reflex were compared between the two groups. Results： There was no significant difference in puncture time， puncture success rate and X-ray exposure time between the two groups (P>0.05). The postoperative compression time of the brachial artery group was significantly shorter than that of the femoral artery group (P<0.05). In the brachial artery group， the incidence of pseudoaneurysm and vagal reflex after removal of the sheath were significantly lower than those in the femoral artery group(P<0.05). Conclusion： In the PCI， the brachial artery approach can be prior to the femoral artery approach as a surrogate pathway after the transradial approach fails.