Department of Endovascular Diagnostics and Treatment

Main activities:

• Carrying out diagnostic coronary angiography, balloon angioplasty and stenting of coronary arteries for femoral and radial access in hospital in patients with ischemic heart disease and patients with non-coronary myocardial lesions and other cardiovascular pathology.
• Balloon angioplasty and stenting of coronary arteries in patients with acute coronary syndrome under conditions of round-the-clock angiographic service (24/7) with the use of mechanical trombectomy.
• Balloon angioplasty and stenting of multivessel coronary lesions, as well as the left main coronary artery using balloon counterpulsation and rotational atherectomy system.
• Diagnostic of coronary artery bypass, balloon angioplasty with stenting of aortocoronary and mammarocoronary bypasses, embolization of mammarocoronary bypass branches.
• Conducting intravascular ultrasound, optical coherence tomography and measurement of the fractional reserve of blood flow to determine the functional severity of coronary stenosis
• Balloon angioplasty and stenting of peripheral arteries (carotid, renal, and arteries of the upper and lower extremities).
• Visualization of the aorta and peripheral vessels
• Endovascular closure of the left atrial appendage in patients with non-valvular atrial fibrillation devices Amplatzer Cardiac Plug and Watchman Device
• Cardiac tissue biopsy, catheterization of the right side of the heart
• Transcatheter aortic valve implantation (TAVI) in patients with severe aortic valve stenosis
• Patent foramen ovale closure and atrial septal defects in patients with cryptogenic stroke.

Scientific activity:

• In addition to modern drug-eluting stents bioresorbable vascular scaffolds have proven their effectiveness and safety. For the first time in Russia, the implantation of stents with a bioresorbable coating was performed in our department. The development of bioresorbable stents, which are completely absorbed within 2 years, has become a new stage in the development of endovascular treatment. Such stents for the first time in Russia were also implanted in our department at the end of 2012. Currently under dynamic observation, and accumulate data in this direction.
• The use of additional invasive diagnostic methods for balloon angioplasty and coronary artery stenting has significantly expanded the indications for percutaneous coronary intervention and increased the efficiency of endovascular treatment. Such methods include intravascular ultrasound (IVUS) and optical coherence tomography (OCT) for the morphological assessment of atherosclerotic plaques, lesion length and arterial diameter, as well as measuring the fractional reserve of blood flow to determine the functional severity of coronary stenosis.
• We have accumulated a wide experience in providing help to the patients with the lesions of the left main coronary artery, which recently served as the major indication for the coronary artery bypass operation. We have mastered new a technique of unprotected left coronory artery trunk angioplasty with the use of rotational atherectomy with or without applying intra-aortic contrapulsation ballon.
• We have acquired a wide experience in endovascular closure of the left atrial appendage with the help of Amplatzer Cardiac Plug and Watchman Device.
• The use of manual thromboextraction during percutaneous coronary intervention in patients with acute myocardial infarction has proven to be an effective and safe method of preventing the no-reflow phenomenon.
• The use of radial access, including for primary percutaneous coronary intervention and stenting of the left main coronary artery, can reduce the incidence of local complications at the puncture site, achieve early activation of patients and reduce the time of their inpatient stay
• Patent foramen ovale (PFO) is common in the general adult population, affecting approximately one in four people, and the risk of stroke appears to be very low overall. However, once patient had a stroke that is likely due to the PFO, he is likely at risk of additional strokes and so closing the PFO may help. The recommendations apply to patients under 60 years old with PFO who have had a cryptogenic ischaemic stroke, when extensive workup for other aetiologies of stroke is negative. We performed PFO closure as an options for the secondary prevention of stroke in patients younger than 60 years who have had a cryptogenic ischaemic stroke thought to be secondary to patent foramen ovale. We are going to organize registry named “FUTURE events prevention with endovascular PFO closure. FUTURE –CLOSURE. Russian registry of PFO closure.”
• We also perform transcatheter closure of secundum atrial septal closure (ASD) by two-disks septal occluder with hemodynamic benefit. Currently it is recommended that the ASD be closed at the time of presentation.
• Transcatheter aortic valve replacement (TAVR) is a minimally invasive heart procedure to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis). Transcatheter aortic valve replacement is sometimes called transcatheter aortic valve implantation (TAVI). TAVR may be an option for people who are at intermediate or high risk of complications from surgical aortic valve replacement (open-heart surgery). Our department have made TAVI with brain protection device, first in Russia. All procedures were made percutaneously, without any access site sections.