In the era of selective and superselective arteriography, vessel tortuosity, even in the presence of good pulses, can impede catheterization of the aorta and its branches. We assessed 101 patients who had femoral arteriography to determine whether there was a significant difference in tortuosity between the right and left sides and to define the degree to which significant tortuosity was bilateral.
Fourteen and 21 patients had tortuosity greater than 1 standard deviation above the mean of the population on the right and left sides, respectively. This difference was not statistically significant. Twenty-three of the 29 patients with tortuosity greater than 1 standard deviation above the mean had this finding unilaterally. There is no advantage to preferentially beginning catheterization on a particular side. Furthermore, since 80% of significant tortuosity is unilateral, the contralateral femoral artery should be approached with only minimal delay when tortuosity that impedes catheterization is encountered.