What type of catheter is commonly used for selective engagement of the left and right coronary arteries in diagnostic angiography?

• A. Swan-Ganz catheters.
• B. Endovascular stent catheters.
• C. Guiding catheters (e.g., Judkins-type) designed for selective coronary engagement.
• D. Sheath introducers.

Answer: (C)

Selective engagement of the left and right coronary arteries in diagnostic angiography is achieved with guiding catheters that have preformed curves designed to fit the coronary ostia. These guiding catheters, such as Judkins-type catheters, are shaped to align with the origins of the coronary arteries from the aorta, giving a coaxial orientation that allows precise and stable selective cannulation and reliable contrast injection into each vessel. The left and right coronaries arise at different angles, so using left- or right-specific curves helps achieve quick, stable engagement with minimal manipulation.

Other catheters aren’t suited for this purpose. A Swan-Ganz catheter is a pulmonary artery catheter used for hemodynamic monitoring, not selective coronary engagement. A stent delivery catheter is intended for PCI to deliver stents, not for diagnostic selective angiography. A sheath introducer merely provides vascular access and does not engage the coronary ostia.