Determining the optimal arterial access in endovascular interventions
Cardiovascular diseases (CVD) are the leading causes of death all-over the world. In Russia 841 175 deaths caused by CVD in 2019 that makes 46.7% of mortality in Russian Federation. Ischemic heart disease and strokes are the reason of 85% of deaths of all cardiovascular diseases. At the present time ration of aorto-coronary bypass and percutaneous intervention with stent placement has changed. In 2017 in Russian Federation 200,000 interventions with stent placement has completed (85% of all interventions on coronary arteries) and 32,000 coronary artery bypass (32%). The main vessel access is the most important part in any invasive procedure that defines that rate of success. The access is chosen by the surgeon (His experience), type of surgery and vessel conditions. Endovascular interventions starts with arterial access and ends up with closing the access that is considered the main safety point for all diagnostic and therapeutic interventions. Decreasing the main access complications, early mobilization after procedures is the main criteria for choosing the site of access. At the current moment many methods of hemostasis are used after invasive procedures but still the manual compression is the leading method for closure of access point after diagnostic catheterization or percutaneous coronary intervention. The main factors for choosing and arterial access are instrument diameters, kind of intervention, multifocal atherosclerosis and somatic condition of patient. Nowadays there is no specific approach in choosing the arterial access and safety of use which needs further comparison and researches.