Overview of the distal radial access from the radial artery occlusion perspective.

Conventional radial access in endovascular surgery has certain limitations, primarily associated with the presence of local complications and radial artery occlusion. Over the past 7 years, distal radial access has exploded into all areas of endovascular procedures, from interventional cardiology to vascular surgery and interventional oncology. However, puncture of the distal radial artery has its own nuances and features: a learning curve, the use of ultrasound navigation in the initial stages of mastering the access, limitations in patients with acute conditions (acute coronary syndrome and stroke). This review aims to analyze on important aspects of the procedure of distal radial access from preparation for it to hemostasis and to explore all data about the new roles of distal radial access in avoiding but also treating radial artery occlusion, as the first thing to begin with the development and implementation of new access.

Some Topical Aspects of the "Sports Heart" Problem. Literature Review. Part 2.

Electrocardiography occupies a special place among a significant list of other methods for diagnosing the pathology of the cardiovascular system of athletes. Often its results differ significantly from those in the general population, being a consequence of the adaptation of the heart to economical functioning at rest and super-intensive work in training and competitions. This review focuses on the features of the "athlete's electrocardiogram (ECG)." In particular, those changes that are not a reason for removing athletes from physical activity, but in combination with known factors can lead to more serious changes up to sudden cardiac death. Fatal rhythm disorders in athletes are described, possible in Wolff-Parkinson-White syndrome, syndrome of ion channel pathology, arrhythmogenic dysplasia of the right ventricle, etc. Particular attention is paid to arrhythmia due to connective tissue dysplasia syndrome. Knowledge of these issues is necessary to choose the right tactics for an athlete with changes to the electrocardiogram and in the protocol of daily Holter monitoring of the electrocardiogram, and a doctor related to sports medicine should be aware of the features of "electrophysiological remodeling" of the athlete's heart, normal and pathological "sports electrocardiogram," about conditions accompanied with the development of serious rhythm disorders and algorithms for examining the cardiovascular system of the athlete.

Noncompaction Cardiomyopathy: Issues, Contradictions, and Search for Effective Diagnostic Criteria. Literature Review. Part 1.

Active research of noncompaction cardiomyopathy (NCM) has been going on for more than 30 years. A significant amount of information has been accumulated that is familiar to a much larger number of specialists than in the most recent past. Despite this, numerous issues remain unresolved, ranging from classification (congenital or acquired, nosology or morphological phenotype) to the ongoing search for clear diagnostic criteria that separate NCM from physiological hypertrabecularity and secondary noncompaction myocardium with the background of existing chronic processes. Meanwhile, a high risk of adverse cardiovascular events in a certain group of people with NCM is quite high. These patients need timely and often quite aggressive therapy. This review of sources of scientific and practical information is devoted to the current aspects of the classification, extremely diverse clinical picture, extremely complex genetic and instrumental diagnosis of NCM, and the possibilities of its treatment. The purpose of this review is to analyze current ideas about the controversial problems of noncompaction cardiomyopathy. The material for its preparation is the numerous sources of databases Web Science, PubMed, Google Scholar, eLIBRARY. As a result of their analysis, the authors tried to identify and summarize the main problems of the NCM and identify the ways to resolve them.

Update in Carotid Disease.

This review of the literature analyzes publications over the past five years on various problems associated with carotid endarterectomy: 1. Is the eversion or classical technique of surgery with plastic repair of the reconstruction area with a patch more effective? 2. Carotid endarterectomy or carotid angioplasty with stenting is more optimal? 3. When should brain revascularization be performed after the development of ischemic stroke? 4. Should a temporary shunt be used to protect the brain during carotid endarterectomy? 5. How to prevent and treat different types of intraoperative ischemic strokes? 6. What tactics of treatment of patients with combined lesions of the carotid and coronary arteries is more effective? 7. What are the causes and methods of elimination of restenosis of the internal carotid artery known? 8. Is carotid endarterectomy safe in old age?

Distal Radial Artery Access in Noncoronary Procedures.

Since the beginning of interventional cardiology and for decades, the femoral artery has been the access of choice for both diagnostic and interventional endovascular procedures. Due to an extensive evidence base accumulated over the last 20 years, the majority of interventional cardiologists around the world prefer classical radial artery access for both elective and emergency procedures. A similar trend has been observed for distal radial artery access over the last 5 years. Noncoronary endovascular surgery undergoes the same stages of improvement and optimization of access, but in a more accelerated way. The goal of this review is to analyze the literature on distal radial artery access in noncoronary procedures.

A narrative review of history, advantages, future developments of the distal radial access.

This article presents a historical excursus and a review of modern literature on distal radial access for interventional surgery, discussing the anatomical and physiological substantiation of the use of this access point in endovascular surgery, its advantages and disadvantages. The main considerations directly related to distal puncture, choice of instrumentation, hemostasis, possible complications, and prevention are analyzed. The major areas of interventional surgery (coronary, vascular, oncological, and neurointerventional), where the distal radial approach is actively used, are reflected and their characteristics are highlighted. In general, it has been shown that with the development of technology, improved manual skills, the widespread use of hydrophilic introducers, and modern sheathless guiding catheters, the vessel diameter, and puncture site are not decisive factors when choosing access for any type of intervention.