Simmons catheters (Sim catheters) have been used for cerebral angiography  as well as renal angiography . They have 3 different varieties (Sim 1, 2 and 3). 4 French and 5 French sizes are available. Sim catheters can be used for transradial as well as transfemoral approaches. Possibility of engaging the left subclavian by the transradial route has made this an option for angiography of the left internal mammary artery (LIMA) when coronary artery bypass is the option after a diagnostic coronary angiography. Sim catheters comes in handy when there is difficulty in engaging the left subclavian artery using the Tiger or Judkins right coronary catheter. LIMA angiography is often needed while evaluating post coronary artery bypass graft patients in whom patency of the LIMA graft has to be documented.
Simmons 1 and 2 are the curves usually selected for transradial cerebral angiography. In a study, 92 out of 103 LIMA grafts could be cannulated selectively or semi-selectively using a modified Simmons catheter producing satisfactory image quality . Modified Simmons catheter is prepared by bending the tip of the catheter (See reference 3 for images).
Inflating the blood pressure cuff on the left arm during non-selective injection (into the left subclavian artery) produces better images of the LIMA. This can be tried when selective cannulation is difficult.
Berman HL, Cornell TJ. A technique for reforming the Simmons curved cerebral catheters. AJR Am J Roentgenol. 1982 Oct;139(4):824.
2. Grable GS, Smith DC. The use of the Simmons “Sidewinder” catheter in percutaneous transluminal angioplasty of the renal arteries. Radiology. 1980 Nov;137(2):541-3.