Objective To determine the correlation between operator experience in distal transradial coronary intervention(dTRI)and the successful cannulation rate of the distal radial artery(DRA),as well as to identify risk factors for punc-ture and cannulation failures.Methods From January 2021 to December 2022,1 000 patients who underwent dTRI via DRA by a single interventionist in Beijing Luhe Hospital were retrospectively enrolled.These patients were chronological-ly ranked and divided into ten groups(100 cases each)according to operation time and order.The primary endpoint was the successful cannulation rate of DRA for every 100 cases,while the secondary endpoints were the success rate of one-time puncture catheterization and puncture catheterization time.Logistic regression analysis was carried out to identify predictors of unsuccessful DRA.Results A total of 1 000 patients were enrolled,with a successful DRA cannulation rate of 92.3%.After 200 cases,this rate stabilized at 93.0%(P=0.075).The first attempt DRA puncture success rate improved from 74.0%to 96.0%,while the median sheath cannulation time decreased from 3.00 min to 2.00 min(P<0.001).Logistic regression analysis showed that a negative association between DRA diameter(P=0.020)and cannula-tion failure,and a positive association with left artery access(P=0.046).Conclusion Achieving over 93.0%success in DRA puncture and cannulation becomes consistent after 200 cases.Small DRA diameter and left-sided access are key predictors of failure.