Coronary Diagnostic Catheters

Diagnostic coronary angiography is most often undertaken either through the femoral route or radial route. Rarely brachial or axillary access may be resorted to if the popular radial or femoral routes are not feasible. Femoral access may be preferred in an emergency when quick arterial access is needed. It is also used when more devices have to be introduced, but seldom the case for diagnostic coronary angiography. The most popular catheter for femoral route is Judkins catheter. Judkins catheter comes in left coronary and right coronary curves. They have a primary curve and a secondary curve. Primary curve engages the coronary ostium while the secondary curve stabilizes the catheter along the opposite wall of the aorta. Large secondary curves are needed when the ascending aorta is dilated. The catheter sizes are referred to depending on the secondary curves and the coronary artery for which it is meant e.g. JL4. Here are the pictures of Judkins left and right coronary catheters. Primary and secondary curves are marked for the right coronary catheter. Another catheter used through the femoral route is the Amplatz catheter. A specialty of Amplatz catheter is that when you wish to disengage the catheter from the coronary ostium, you have to push the catheter rather than withdraw it. If you try to withdraw it, the catheter gets more deeply engaged. Amplatz right coronary catheter can be used to cannulate right coronary arteries with abnormal, usually, an inferior origin. Amplatz left coronary catheter is used to engage left coronary ostia which are difficult to cannulate with Judkins left coronary catheter. It is useful in case of short left main stem and separate origins of left anterior descending and left circumflex coronary arteries. Amplatz left coronary catheter is also used to engage high anterior right coronary arteries or Shepherd’s Crook RCA. Sones catheter is used for coronary angiography via the brachial route. Same catheter is used for engaging right and left coronary artery. Tiger catheter is the most popular catheter for transradial coronary angiography. Same catheter can be used for the right and left coronary angiograms. Picture of a tiger diagnostic coronary catheter. As catheter exchange is avoided, chance for radial artery spasm is lesser.