Endovascular biometrics and engineering

Abstract

Aim. To study technical problems in the provision of endovascular care and to develop technological solutions for its improvement based on endovascular biometry. Methods. For the period 2015–2019 an expert analysis of the results of endovascular treatment of 1546 patients with chronic lower limb ischemia was performed, in which it was not possible to perform lower limb revascularization according to the standard method using a guide catheter, guidewire and balloon catheter. The expert group inclu­ded 5 interventional radiologists who performed endovascular procedures. The results were assessed by the effectiveness of revascularization using the developed innovative technology from a system of catheters of various diameters and stiffness in comparison with the results of using standard endovascular technique. Calculation of adequate statistical indicators and their reliability were undertaken using Statistica software (version 6.0). Results. The “critical” and “weak” zones of the vascular bed were identified for the first time to substantiate the development of a technology for safe and effective endovascular revascularization. It has been established that technical difficulties in catheterization of vessels create the prevalence of atherosclerotic lesions and the limited technical capabilities of catheters and guidewires, which are manipulated under the conditions of increasing high friction with the vessel wall caused by tortuosity and atherosclerosis, the presence of “weak” and “critical” zones of the blood vessels, as well as a significant distance from the surgeon's hands to the area of medical manipulation, ­reaching 130–200 cm. The developed innovative design from the catheter system ensured the effectiveness of endovascular lower limb revascularization in all patients (100%) using the femoral and brachial accesses compare to the standard technique of endovascular care (p <0.001). Conclusion. Endovascular instruments offered on the domestic market do not guarantee the effective completion of revascularization. The technology of vascular catheterization developed based on endovascular biometry ensures the successful completion of revascularization in 100% of cases.