kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2018-7-4-112-120kpccz-488Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОРANALYTICAL REVIEWКАРОТИДНОЕ СТЕНТИРОВАНИЕ ТРАНСРАДИАЛЬНЫМ ДОСТУПОМTRANSRADIAL APPROACH FOR CAROTID ARTERY STENTINGМалаевД. У.MalaevD. U.

Малаев Дастан Урматович, врач по рентгенэндоваскулярным диагностике и лечению, аспирант

Центр новых хирургических технологий

ул. Речкуновская, 15, Новосибирск, 630055

Malaev Dastan U., interventional cardiologist, PhD student

15, Rechkunovskaya Street, Novosibirsk, 630055

dastan.kgma@gmail.comКретовЕ. И.KretovE. I.

Кретов Евгений Иванович, кандидат медицинских наук, ведущий научный сотрудник центра интервенционной кардиологии, врач по рентгенэндоваскулярным диагностике и лечению

Центр новых хирургических технологий

ул. Речкуновская, 15, Новосибирск, 630055

Kretov Evgeniy I., MD, PhD, leading researcher at the Center for Interventional Cardiology, interventional cardiologist

15, Rechkunovskaya Street, Novosibirsk, 630055

БайструковВ. И.BaystrukovV. I.

Байструков Виталий Игоревич, кандидат медицинских наук, врач по рентгенэндоваскулярным диагностике и лечению

Центр новых хирургических технологий

ул. Речкуновская, 15, Новосибирск, 630055

Baystrukov Vitaliy I., PhD, interventional cardiologist

15, Rechkunovskaya Street, Novosibirsk, 630055

ПрохорихинА. А.ProkhorikhinA. A.

Прохорихин Алексей Андреевич, врач по рентгенэндоваскулярным диагностике и лечению, аспирант

Центр новых хирургических технологий

ул. Речкуновская, 15, Новосибирск, 630055

Prokhorikhin Alexey A., interventional cardiologist, PhD student

15, Rechkunovskaya Street, Novosibirsk, 630055

БойковА. А.BoykovA. A.

Бойков Андрей Александрович, врач по рентгенэндоваскулярным диагностике и лечению, аспирант

Центр новых хирургических технологий

ул. Речкуновская, 15, Новосибирск, 630055

Boykov Andrey A., interventional cardiologist, PhD student

15, Rechkunovskaya Street, Novosibirsk, 630055

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени акад. Е.Н. Мешалкина» Министерства здравоохранения Российской ФедерацииРоссияE. Meshalkin National Medical Research CentreRussian Federation20181812201874112120Copyright © Малаев Д.У., Кретов Е.И., Байструков В.И., Прохорихин А.А., Бойков А.А., 20182018Малаев Д.У., Кретов Е.И., Байструков В.И., Прохорихин А.А., Бойков А.А.Malaev D.U., Kretov E.I., Baystrukov V.I., Prokhorikhin A.A., Boykov A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/488

Примерно 20% ишемического инсульта приходится на долю стенотического поражения каротидных артерий. С ростом опыта хирургов и продолжающимся усовершенствованием устройств каротидное стентирование (КС) стало эффективной альтернативой каротидной эндартерэктомии. Традиционным доступом при КС является трансфеморальный (ТФ) доступ. Однако из-за заболеваний периферических артерий, сложной анатомии дуги аорты ТФ-доступ не всегда может быть выполним. Множество рандомизированных исследований доказали эффективность и безопасность трансрадиального (ТР) доступа при коронарных вмешательствах. Аналогичная техника была адаптирована для КС. Таким образом, данная статья является обзором наиболее значимых исследований, посвященных КС ТР-доступом, поиску преимуществ и недостатков, а также выбору оптимального сосудистого доступа в зависимости от анатомических особенностей пациента. ТР-доступ является достойной альтернативой ТФ при КС, однако он сопровождается высокой частотой неуспеха процедуры по сравнению с ТФ-доступом. Использование ТР-доступа сопровождается снижением частоты сосудистых осложнений и является предпочтительным при вмешательстве на правой ВСА или на левой при бычьей дуге аорты.

Approximately 20% of ischemic strokes are provoked by stenotic carotid artery lesions. With the growing experience of surgeons and the continued improvement of devices, carotid artery stenting has become an effective alternative to carotid endarterectomy. Traditional access to carotid artery stenting is transfemoral approach. However, due to peripheral artery disease and challenging anatomy of the aortic arch, transfemoral approach may be problematic. A number of randomized trials have proven the effcacy and safety of transradial access for coronary interventions. A similar technique was adapted for coronary artery stenting. The article provides a review of the major studies dedicated to coronary artery stenting via transradial approach, discusses all benefts and limitations as well as provide the guide to select an optimal vascular access, depending on the patient's anatomical characteristics. Transradial approach is shown to be a good alternative to transfemoral approach for coronary artery stenting. However, it is accompanied by a high rate of unsuccessful procedures compared to transfemoral approach. Nevertheless, transradial approach is accompanied by a decrease in the rate of vascular complications, and is preferable for intervening on the right ICA, or on the left with bovine aortic arch.

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The authors declare that there are no conflicts of interest present.