Aortic aneurysm: an independent predictor of a looped brachiocephalic trunk in patients undergoing transradial coronary angiography.
BACKGROUND
A looped brachiocephalic trunk may cause transradial coronary angiography (TRA) failure with a right radial approach. The prevalences of aortic aneurysm (AA) and a looped brachiocephalic trunk are closely related to increased age.


OBJECTIVE
The aim of this study was to clarify the relationship between AA and a looped brachiocephalic trunk.


METHODS
A total of 1306 consecutive patients who underwent TRA through the right radial artery at Keio University Hospital between January 2007 and December 2011 were examined retrospectively. A looped brachiocephalic trunk was defined as the presence of a full 360° loop in the 45° left anterior oblique view requiring a change in the access site to the left radial or femoral artery.


RESULTS
Of the 1306 patients who underwent TRA at Keio University Hospital between January 2007 and December 2011, 137 had AA. The patients were divided into two groups: patients with a looped brachiocephalic trunk and those without it. Patients in the looped brachiocephalic group were older and had a higher BMI. The prevalence of hypertension was higher in the looped brachiocephalic trunk group. Creatinine clearance was lower in patients with a looped brachiocephalic trunk than in those without a looped brachiocephalic trunk. Multivariate analysis showed that AA was an independent predictor of a looped brachiocephalic trunk.


CONCLUSIONS
AA is a predictor of a looped brachiocephalic trunk that should be considered in patients undergoing TRA.
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Satoshi
S
Mogi
Yuichiro
Y
Maekawa
Masaki
M
Kodaira
Atsushi
A
Anzai
Takahide
T
Arai
Takashi
T
Kawakami
Kentaro
K
Hayashida
Shinsuke
S
Yuasa
Akio
A
Kawamura
Keiichi
K
Fukuda
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000453:epidemiology*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000473:pathology*; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006785:Hospitals, University; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D017534:Radial Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012307:Risk Factors