Comprehensive CT Assessment of Subclavian Artery Tortuosity: Implications for Optimal Radial Access Selection
Authors' conclusion
RSA tortuosity is significantly more frequent and pronounced than LSA tortuosity and is associated with age ≥80 years, female sex, prior stroke, and thoracic kyphosis. Elevated tortuosity contributes to longer coronary angiography procedures.
Study context
- Population
- Patients undergoing contrast-enhanced CT and coronary angiography as pre-aortic valve replacement work-up
- Participants
- 695 consecutive patients
- Exposure
- Right subclavian artery (RSA) vs left subclavian artery (LSA) tortuosity
- Outcome
- Subclavian tortuosity index (centerline-to-straight-line distance ratio from 3D reconstruction)
Methodological detailsconsecutive patients, CALCI-TAVI cohort
- Consecutive patients
- CALCI-TAVI cohort
Main finding
As reported in the abstract
Tortuosity index
RSA
51.8
range as printed 38.6–70.4
LSA
40.00
range as printed 28.30–54.39
P < 0.001
Observational data: associations, not effects.
Further findings
Fluoroscopy time, high vs lower tortuosity
P = 0.001
Independent predictors of high RSA tortuosity
- Age ≥80 years, female gender, prior stroke, thoracic kyphosis
- P < 0.05 for all
- Multivariable logistic regression
Original publication
Comprehensive CT Assessment of Subclavian Artery Tortuosity: Implications for Optimal Radial Access Selection. JACC Adv. Published 4 December 2025. doi:10.
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