Selective access catheters

Last revised by Yahya Baba on 4 Oct 2023

Selective access catheters are designed for catheterization and subselection of vessel ostia, biliary, urogenital, or digestive tracts. They come in different tip shapes that have wall-seeking behavior. They also ensure the advancement down the target destination and provide positional stability during subsequent opacification and manipulation.


They come in different materials, tip-shape, lengths, number and size of side holes, pressure rates, volume rates, and radiopacity.

Size and length

French-size: 4 to 6 F.

Lengths: from 40 to 125 cm.

Side holes

Most selective catheters have a single end hole1.


They have a rotational stiffness that allows accurate manipulation transmission from the hub to the tip.

Pressure and volume rates

Single-end hole catheters require low flow rates compared to flush catheters since side holes reduce the end-hole jet effect2.

Hydrophilic coating

They can be hydrophilic or non-hydrophilic.

Hydrophilic coating allows smooth gliding through vessels, but reduces stability and rotational stiffness.

Catheter curves
  • primary curve - the closest to the tip

    • must approximate the takeoff angle of the target ostium to allow for the selection and maintenance of the tip within the vessel

  • secondary curve

    • should approximate the form of the main trunk vessel - tortuosity should be taken into account3

    • allows the advancement of the catheter into the target vessel.

  • tertiary curve - behind the secondary curve

    • maintains a firm catheter position by opposing the back vascular wall of the target ostium (e.g. Mikaelsson catheter)

    • turns a floppy tip in midstream into a stable device ready to engage the target ostium

    • this curve creates a vascular contact that redirects the vertical pushing force towards the desired ostium axis.

Tip shapes

The main factors that influence the choice of tip shape are:

  • diameter of the trunk vessel

  • angle of the target vessel ostium

The shape and length of the tip should be adapted to the ostium to avoid catheter dislodgment after vessel selection.

Cerebral selective catheters

Left internal mammary artery access catheters

  • LIMA

  • modified LIMA

  • judkins right

Bronchial artery access catheters

The upper limb route (e.g. radial, brachial) is not adapted for bronchial artery access.

Right coronary artery access catheters4

Left coronary artery access catheters4

Celiac artery access catheters

Renal artery access catheters

Renal vein access catheters

Superior mesenteric artery access catheters

Inferior mesenteric artery access catheters

Lumbar artery access catheters

The upper limb route (e.g. radial, brachial) is not adapted for lumbar artery access.


Bile ducts / urinary access catheter

Angled selective catheter


To decrease the risk of vascular injury:

  • catheters should always be inserted and withdrawn over wires, as the tip of catheters moving within a vessel can cause dissection

  • always verify the catheter's pressure rate limit while using the power injector since surpassing these thresholds can damage both the catheter and the blood vessel.

Catheters with side holes are not suited for embolization as this increased the risk of non-target vessel embolization.

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