Endoscopic optical coherence tomography (OCT) catheters comprise a transparent tube to separate the imaging instrument from tissues. This tube acts as a cylindrical lens, introducing astigmatism into the beam. In this report, we quantified this negative effect using optical simulations of OCT catheter devices, and discuss possible compensation strategies. For esophageal imaging, the astigmatism is aggravated by the long working distance. For intracoronary imaging, the beam quality is degraded due to the liquid imaging environment. A nearly circular beam profile can be achieved by a curved focusing optics. We also consider the method of matching refractive indices, and it is shown to successfully restore a round beam.