LITERATURE REVIEW
Coronary artery disease
Coronary artery disease (CAD) is the leading health burden in developing and developed countries; is responsible for one-third of all deaths in adults over the age of 35 worldwide In Vietnam, coronary artery disease has also become one of the headmost causes of mortality In 2016, according to a report by WHO, it was estimated that 31% of deaths in Vietnam were due to cardio disease, of which more than half were due to coronary artery disease.
Atherosclerotic coronary artery disease includes two clinical syndromes:
Figure 1 1 Diagnosis of acute coronary syndromes [53]
Chronic coronary syndrome is a new term introduced at the European Society of Cardiology (ESC) 2019, instead of stable angina pectoris, stable CAD, chronic ischemic cardiomyopathy, or coronary insufficiency.
Acute coronary syndromes (ACS) include ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), unstable angina (UA) (Figure 1.1)
Approach to acute coronary syndromes (Figure 1.2)
Figure 1 2 Approach to acute coronary syndromes [53]
Percutaneous coronary artery imaging and intervention (PCI)
Percutaneous coronary angiography and intervention are the gold standards in the diagnosis and treatment of coronary artery disease.
1.2.1 Intravascular access in coronary angiography and intervention
One of the most essential steps in percutaneous coronary angiography and intervention is the vascular access selection Selectable entry sites are the femoral artery, brachial artery, or radial artery However, regardless of artery location, the instrument, technique, and experience of the surgeons play an essential role in ensuring the success of the procedure and minimizing the risk of associated complications.
Complications related to the puncture site not only affect the effectiveness of the intervention but can also alter patient outcomes A study by Mamas et al in 2013 of 46,128 patients undergoing coronary angiography and intervention showed that radial bypass was an independent factor in reducing 30-day mortality (HR 0.71 CI
95) %: 0.52 - 0.97 with p