“If you do large bore access, at some point you will encounter patients that will require alternative access,” Joaquim Barboza, MD explains. After identifying alternative access options, Dr. Barboza focusses on axillary access, highlighting this content with brief patient cases. He describes the anatomy of the axillary artery and the region surrounding it and presents best practices, such as shallow angle micropuncture stick, for vascular access. He also describes closure techniques and strategies for managing complications. Dr. Barboza is an interventional cardiologist at University of Illinois at Chicago (UIC).