Prediction of Judkins Left Catheter Size during Left Transradial Coronary Angiography by Simple Chest Radiographic and Echocardiographic Index.
Seong Soon KwonByoung Won ParkDuk-Won BangMin-Ho LeeMin-Su HyonSeong-Soo LeePublished in: Medicina (Kaunas, Lithuania) (2021)
Background and Objectives: Appropriate catheter selection when conducting transradial coronary angiography (CAG) helps shorten examination time, preventing vascular complications and lowering medical expense. However, catheter selection is made based on the practitioner's experience in almost all cases. Therefore, we undertook this study to define radiologic and echocardiographic indices that would enable physicians to anticipate appropriate catheter selection. Materials and Methods: This is a retrospective study of 244 undergoing transradial diagnostic CAG at an established center from February 2006 to April 2014. Patients who successfully underwent angiography with a JL3.5 catheter were defined as the control group, and patients who successfully underwent angiography after the catheter was replaced with a JL4.0 or higher were defined as the switched group. To identify predictors for appropriate catheter selection, radiologic and echocardiographic indices were analyzed. Results: A total of 122 patients in the switched group and 122 patients in the control group were analyzed in this study. Average age was 64.65 ± 8.6 years. In the radiographic index, the switched group exhibited a significantly higher mediastinal-thoracic ratio (0.27 ± 0.05 vs. 0.23 ± 0.03, p < 0.001. Additionally, the mediastinal-cardiac ratio was significantly greater in the switched group (0.50 ± 0.08 vs. 0.45 ± 0.05, p < 0.001). Aortic root diameter, which is used here as the echocardiographic index, was significantly larger in the switched group compared to the control group (34.94 ± 4.18 mm vs. 32.66 ± 3.99 mm, p < 0.001). In the multivariable logistic regression model, mediastinal-cardiac ratio (OR 5.197, 95% CI 2.608-10.355, p < 0.001) and increased aortic root (OR 2.115, 95% CI 1.144-3.912, p = 0.017) were significantly associated with catheter change. Conclusions: Mediastinal-cardiac ratio and aortic root diameter provide helpful and effective indices for appropriate catheter selection during transradial coronary angiography.
Keyphrases
- ultrasound guided
- left ventricular
- ejection fraction
- end stage renal disease
- lymph node
- mitral valve
- percutaneous coronary intervention
- pulmonary hypertension
- chronic kidney disease
- newly diagnosed
- primary care
- prognostic factors
- healthcare
- heart failure
- aortic valve
- optical coherence tomography
- coronary artery disease
- peritoneal dialysis
- patient reported
- risk factors
- acute coronary syndrome
- atrial fibrillation
- aortic dissection
- pulmonary arterial hypertension