Abdulameer Jasim Jawad Al‑Gburi*
Department of Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
Abstract
Objectives: Proper catheter selection during right trans‑radial coronary angiography reduces procedure duration, costs, and vascular complications. The correlation between aorta morphological parameters assessed through computed tomography (CT) and requirement for larger catheter size was investigated in this study. Materials and Methods: This observational study includes 206 patients who underwent right trans‑radial coronary angiography and had already undergone coronary CT angiography at a recognized center from April 2023 to January 2025. Patients who completed angiography using a Judkins left (JL) 3.5 (Group 1) catheter were compared with patients who required catheter exchange with a JL 4 or larger (Group 2). Both groups had their CT images analyzed for four specific aortic morphological variables. Results: A total of 167 patients formed Group 1, whereas 39 patients formed Group 2. The significant differences were detected in the maximal area and length of the ascending aorta among the four aortic CT variables. In multivariable logistic regression model, the strongest association with the need for JL4 or more catheter (Group 2) was found with the maximal area of the ascending aorta (odds ratio [OR] 31.82 [(95% confidence interval [CI]) 1.21–831.18], P < 0.001) followed by length of the ascending aorta (OR 29.97 [(95% CI) 1.06–845.08], P < 0.001). An ascending aorta maximal area cutoff value was 12.25 cm2 (SN 94.9%, SP 95.2%) with the derived diameter of 3.94 cm. Conclusion: Maximum area (with derived diameter) and ascending aortic length were the good predictors for suitable catheter selection during right trans‑radial invasive coronary angiography.
Keywords: Aortic morphology, Coronary angiography, Coronary diagnostic catheters, Left coronary artery, Trans‑radial coronary angiography
