Abstract:

Introduction: the importance of intravascular diagnostic methods and the frequency of their use in clinical practice is steadily increasing. However, in the Russian Federation, studies on the analysis of possibilities of intravascular imaging or physiology are sporadic, and statistical data are presented only in very generalized form. This makes it relevant to create a specialized register dedicated to these diagnostic methods.

Aim: was to present the structure, tasks and possibilities of the Russian registry for the use of intravascular imaging and physiology based on results of the first year of its operation.

Material and methods: In total, in 2021, forms were filled out for 2632 studies in 1356 patients.

Studies included all types of intravascular imaging and physiology - intravascular ultrasound, optical coherence tomography, measurement of fractional flow reserve and non-hyperemic indices.

The registry's web-based data platform includes 14 sections and 184 parameters to describe all possible scenarios for applying these methodologies. Data entry is possible both from a stationary computer and from mobile devices, and takes no more than one minute per study. Received material is converted into Excel format for further statistical processing.

Results: 13 departments participated in the register, while the share of the eight most active ones accounted for 97,5% of all entered forms. On average, 1.9 studies per patient were performed, with fluctuations between clinics from 1,6 to 2,9. Studies of the fractional flow reserve accounted for 40% of total data array, intravascular ultrasound - 37%, optical coherence tomography - 23%. Of all studies, 80% were performed on coronary arteries for chronic coronary artery disease, 18% - for acute coronary syndrome, 2% were studies for non-coronary pathology. In 41% of cases, studies were performed at the diagnostic stage, without subsequent surgery. In 89,6% of cases, this was due to the detection of hemodynamically insignificant lesions, mainly by means of physiological assessment. In 72% of cases, the use of intravascular imaging or physiology methods directly influenced the tactics or treatment strategy - from deciding whether to perform surgery or not to choose the optimal size of instruments or additional manipulations to optimize the outcome of the intervention. In the clinics participating in the register, the equipment of all major manufacturers represented on the Russian market was used.

Conclusions: the design of the online registry database is convenient for data entry. Participation in the registry of most departments that actively and systematically use methods of intravascular imaging and physiology ensured the representativeness of obtained data for analysis in interests of both practical medicine and industry, as well as for scientific research in the field of intravascular imaging and physiology. The register has great potential for both quantitative and qualitative improvement.

Abstract:

Aim. Was to assess the safety and efficiency of ulnar artery catheterization for diagnostic coronarography and endovascular treatment in patients with coronary arteries diseases.

Materials and methods. The study includes 150 patients with coronary arteries disease middle aged 57±9 yrs, underwent diagnostic coronarography and ballon angioplasty with stenting from ulnar artery port (UAPo). Comparative group consisted of 150 patients middle age 58±9 with radial artery port (RAPo).

Results. Technical success of procedure was 96,7 % (145 pts) in group with UAPo and 95,3% (143 pts) in RAPo group. Ulnar artery puncture failed in 5 cases (3,3%): in 3 (2%) cases due to ulnar artery spasm; in 1 case due to impossibility of guide insertion; in 1 case due to failure of ulnar artery puncture. In RAPo group puncture failed in 7 cases (4,7%): in 4 cases due to artery spasm; in 2 cases of guide insertion impossibility and in 2 cases of ulnar artery puncture failure. Time of puncture in UAPo group was 2,6±1,1 min, in RAPo - 2,6±1,2. Time of radiation was 5,5±5,2 min against 6,0±4,6 min in RAPo group. Time of procedure was 29,5±18,4 min in UAPo group against 32,9±16,8 min. The difference of indicators was doubtful in all cases

Complications: thrombosis of ulnar artery appeared in 1 patients at the 2nd day after procedure, thrombosis of radial artery - in 4 cases (2,7%). Spasm of ulnar artery appeared more rarely, than radial artery: 6 cases (4%) against 25 cases (16,7%). In 1 case in RAPo group during puncture we noticed appearance of bradycardia and hypotonia. Local neurological complications were not noticed.

Conclusion: the use of ulnar artery catheterization for diagnostics and treatment is safe and effective. The quantity of complication is lover than in RAPo group. 

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