Diagnostic and Guide Catheter Choices for Upper Extremity Access.

In transradial PCI, selecting an appropriate guiding catheter shape is crucial to ensure sufficient backup support due to the different entry angle into the ascending aorta from the femoral approach. For the left coronary artery, catheters such as Voda, XB, EBU, and Backup types offer strong support via deep insertion but pose a higher risk of ostial dissection. The Ikari L catheter provides safer engagement with lower dissection risk and can match the backup support. For the right coronary artery, while Amplatz L offers strong support, Ikari L minimizes aortic valve regurgitation and enhances support in the Power Position.