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. PATIENTS AND 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. CONCLUSION: AA is a predictor of a looped brachiocephalic trunk that should be considered in patients undergoing TRA.