Background. Despite growing interest in studying the anatomical characteristics of the thoracic aorta, the current evidence base remains insufficient.

Objective. To analyze the features of anatomy of the thoracic aorta and its branches in patients with aneurysmal pathology of the aortic root and ascending aorta.

Patients and methods. This retrospective study included 81 patients with aneurysmal pathology of the proximal thoracic aorta. They were divided into two groups based on the extent of the pathological process: an ascending aortic aneurysm with a normal aortic root (AAA, n=47) and a tubular ascending aortic aneurysm with root involvement (AAAR, n=34). A comparative analysis of the anatomical features of the aorta and its branches was conducted.

Results. Patients with isolated ascending aortic aneurysms were statistically significantly more likely to have bicuspid aortic valve disease (p=0.043) and aortic valve stenosis (p=0.005). The aortic valve annulus size was statistically significantly larger in patients with a combined root and ascending aortic aneurysm (p=0.002), as were the thoracic aortic diameters at all analyzed levels. There were no statistically significant differences in thoracic aortic length between groups. Patients with local ascending aortic aneurysms were more likely to have aortic arch vascular anomalies than those with root and ascending aortic aneurysms.

Conclusion. Patients with both isolated tubulars ascending aortic aneurysms and ascending and root aortic aneurysms had comparable aortic status. At the same time, there are a number of important intergroup differences, which suggests the need to consider these patients from the perspective of different variants of the same pathology, especially when implementing a personalized approach to the diagnosis and monitoring of these patients.

This article presents literature data on the history, mechanism of action, clinical application, and effectiveness of lumbar sympathectomy in the treatment of lower extremity ischemia. The results of numerous studies are compared and the seminal works on this topic are examined in more detail, with a particular focus on systematic reviews. It concludes that lumbar sympathectomy remains a recommended surgical procedure when other treatments are impossible or ineffective.

Objective. Comparative analysis of the content of angiogenesis regulatory proteins in patients presenting with chronic lower limb ischemia (CLLI) and undergoing either surgical treatment or conservative therapy supplemented with local administration of autologous platelet lysate.

Patients and methods. The study included a total of 26 patients with CLLI. Of these, 10 patients (Group 1) were subjected to surgical treatment and 16 (Group 2) underwent conservative therapy alone supplemented with local administration of autologous platelet lysate. The Luminex platform was used to determine the concentration of angiogenic factors EGF, Ang-1, TIE2, VEGF-A, VEGF-R2 in blood of all patients before and 24 hours after surgery (Group 1) or local administration of autologous platelets (Group 2). We also examined the aliquots of the used autologous platelet lysate and blood plasma of 8 apparently healthy volunteer donors. The obtained data were processed using methods of variation statistics.

Results. In chronic ischemia of lower extremities, the concentration of VEGF-A, TIE-2 and VEGF-R2 in blood plasma increased. Group 1 patients demonstrated higher concentrations of Ang-1 and VEGF- A. After surgical restoration of blood flow in the lower extremities, the concentration of cytokines studied did not significantly change. The concentration of EGF, Ang-1 and VEGF-A factors in platelet lysates was significantly higher than in the patients’ blood plasma. After local administration of autologous platelets, the concentrations of these factors in the blood plasma of Group 2 patients did not change compared with the baseline values, but there was a significant decrease in the levels of TIE-2 and VEGF-R2.

Conclusion. Ischemic tissue damage in CLLI is accompanied by an increase in plasma concentrations of angiogenic factors VEGF-A, VEGF-R2 and TIE-2. Administration of autologous platelet lysate into the ischemic zone does not lead to an increase in the levels of VEGF-A, angiopoietin 1 and EGF in the systemic bloodstream. One of the factors contributing to improved microcirculation in patients with CLLI may be a decrease in plasma levels of VEGF-R2 and TIE-2 after administration of autologous platelet lysate into the ischemic zone. The obtained results suggest further research in this field, with the wide clinical application requiring larger cohorts.

Background. Lower extremity artery disease, or peripheral artery disease (PAD), is a common form of atherosclerosis associated with an increased risk of cardiovascular diseases and mortality. Patients with PAD are found to have atherosclerotic lesions of not only lower limb arteries but also those of other basins, as well as microcirculation disorders. This can manifest as decreased functions of blood-supplied organs. Sulodexide is a balanced mixture of highly purified naturally occurring glycosaminoglycans (GAGs): a fast-moving fraction of heparin and dermatan sulfate, beneficially influencing the endothelium of the arterial, venous and microcirculatory bed.

The ANDANTE study is devoted to investigating the effect of sulodexide on health-related quality of life of patients with PAD. Besides quality of life, of interest are ANDANTE-studied parameters associated with physical and cognitive functions.

Objective. To describe secondary endpoints in the ANDANTE study: pain-free walking distance, self-assessment of walking quality, the ankle-brachial index, as well as cognitive and erectile functions.

Patients and methods. The study included a total of 229 both-gender, 37-to-90-year-old patients presenting with stage IIa–IIb PAD and taking oral sulodexide at a daily dose of 500–1000 LSU.

After the screening visit, the participants underwent 4 follow-up visits, assessing health-related quality of life according to the SF-36 questionnaire, pain-free walking distance, the ankle-brachial index, walking ability according to the WELCH questionnaire, self-assessment of maintaining an erection (for men), and cognitive function according to the Hasegawa’s Dementia Scale.

The participants were stratified depending on the number of the given packs of sulodexide (<6 packs or ≥6 packs, with 60 capsules per pack) and the duration of treatment (≤3 or >3 months of treatment). The daily dose of sulodexide amounted to either 500 LSU or 1000 LSU depending on the physician’s recommendation.

Results. The pain-free walking distance increased during 6 months of treatment from 327.3±258.2 to 565.7±490.9 m (p<0.01), with the increment amounting to 237.1±434.6 m, or 72.4%. The ankle-brachial index increased from 0.70 to 0.77 by 10.0% (p=0.01). The average score of self-assessment of walking ability by the WELCH scale significantly increased in the overall population from 21.2 to 36.4 by 71.0% (p<0.01). The average score of self-assessment of erection maintaining on the 3-point scale increased from 2.7 to 3.2 by 14.8% (p<0.01). The participants also demonstrated improved cognitive function by the Hasegawa’s Dementia Scale from 23.8 to 26.7 points by 12.2% (p<0.01). All alterations were similar in the subgroups with different duration of treatment and different course dose of sulodexide.

Conclusion. The ANDANTE study showed efficacy of sulodexide in patients with PAD. Taking sulodexide at a daily dose of 500–1000 LSU resulted in a statistically significant increase in the painless walking distance by 72.4%, improvement of self-reported walking ability by 71.0%, self-assessment of maintaining an erection by 14.8%, and cognitive function by 12.2%. These results were consistent irrespective of both whether the patients were given <6 or ≥6 packs of sulodexide and whether they took it for ≤3 or >3 months.

Introduction. Acute coronary syndrome without ST-segment elevation remains a highly relevant problem due to the heterogeneity of the patient population and the poor prognosis in high-risk groups. Identifying risk factors in this patient group will improve the outcomes of open myocardial revascularization.

Aim – to identify factors for adverse outcome of coronary artery bypass grafting in patients with high-risk non-ST-segment elevation acute coronary syndrome.

Material and methods. Over an eight-year period, 209 emergency coronary artery bypass grafting surgeries were performed within the first 24 hours of admission for high-risk non-ST-segment elevation acute coronary syndrome. Two groups were formed based on the development of major cardiovascular events in the postoperative period: those with such events (Group 1, n=20) and those with a favorable hospital course (Group 2, n=189). Univariate and multivariate regression analyses were conducted, and a prognostic model was developed.

Results. Univariate analysis showed that age over 67 years, Syntax score over 30 points, residual Syntax score over 5, GRACE over 155 points, EuroSCORE II over 4.1%, cardiopulmonary bypass time over 80 minutes, post-CABG urea over 8.3 mmol/l, and glomerular filtration rate under 67 ml/min were factors for unfavorable outcome. A prognostic model was developed, according to which the need for transfusions after surgery increased the risk of unfavorable outcome by 6.5 times, EuroSCORE II over 4.1% by 5.7 times, GRACE over 155 points by 7.4 times, and Syntax score over 30 points by 4 times

Conclusion. Independent predictors of the development of MACE after urgent coronary artery bypass grafting for high-risk acute coronary syndrome without ST segment elevation are: high risk according to the GRACE (>155 points) and EuroSCORE II (>4.1%) scales, severe coronary artery disease (SYNTAX >30 points), as well as the development of the need for transfusions of blood components in the postoperative period.

Background. In modern articles contains many studies devoted to various surgical treatment strategies for concomitant coronary and carotid artery disease. However, all studies address this issue only in patients with stable coronary artery disease and do not provide any recommendations on strategies for patients with ACS who are diagnosed with significant carotid artery stenosis be for interventions. Therefore, the decision on a specific approach is left to the discretion of the cardiac team at individual clinics.

The aim of our study was to evaluate the results of a staged and simultaneous approach to surgical treatment in patients with significant coronary artery stenosis and acute coronary syndrome.

Material and methods. From January 2014 to October 2025, 10 447 patients with ACS were treated in our Center, of which 1423 (13.6%) underwent CABG. Retrospectively, with a continuous sample, 188 (13.2%) patients were included in study with concomitant stenosis carotid and coronary basins. In 134 (71.3%) cases was performed staged intervention and in 54 cases (28.7%) was simultaneous intervention. The average age of patients in the groups was 65.4±7.4 and 64.2±7.4 years (p=0.292). The study was dominated by men (70.7%). The average number of affected vessels was 3.2±0.9. Overall EuroSCORE II was 5.7±2.8%

Results. Mortality in the groups no differ 2.9 and 5.5% (p=0.396). The groups no differ in the conditions of the surgery: on pump, off pump. Also, the groups no differ in surgery-related complications. Simultaneous group statistically stayed longer in the intensive care unit p<0.05. The average follow-up period for the group of staged and simultaneous interventions was 67 and 59.5 months, respectively. The 5-year survival rate was 90.8 and 89.2% (Log-rank test, p=0.332). Freedom from AMI at 5 years was 89.6 and 91.3% (Log-rank test, p=0.545). Freedom from stroke at 5 years was 94.2 and 93.8% (Log-rank test, p=0.386). Freedom from re-interventions at 5 years was 89.6 and 91.3% (Log-rank test, p=0.545).

Conclusion. Rational choice of surgical treatment strategy, strict adherence to the internal protocol for selection of high-risk surgical patients with combined of carotid and coronary arteries lesions, allows for staged and simultaneous interventions with an acceptable risk of mortality and complications in an experienced center.

Background. Arterial hypertension is present in most patients with ischemic stroke and is frequently associated with significant internal carotid artery (ICA) stenosis. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the primary techniques for carotid revascularization; however, their long-term effects on blood pressure control remain debated, particularly given the role of the carotid body in regulating sympathetic activity.

Objective – to assess how the chosen method of carotid reconstruction influences the long-term course of arterial hypertension.

Methods. This single-center, randomized, open-label study enrolled 155 patients with unilateral hemodynamically significant ICA stenosis (70–99%) and resistant grade 2–3 hypertension. Group 1 (n=53) underwent CAS, and Group 2 (n=102) underwent CEA with mandatory carotid body excision. Follow-up exceeded 36 months. Changes in systolic blood pressure (SBP) were evaluated using 24-hour ambulatory monitoring, remote monitoring, and analysis of patient self-monitoring diaries.

Results. During the first postoperative year, both groups demonstrated a significant reduction in SBP (p<0.001) with no between-group difference in magnitude (p=0.688). Beyond one year, significant differences emerged: SBP reduction after CEA was greater (median − 45 mmHg) than after CAS (-20 mmHg; p<0.001). The antihypertensive effect remained stable in the CEA group, whereas a tendency toward SBP increase relative to the 1-year follow-up was observed after CAS. Target blood pressure was achieved in 62.8% of patients after CEA and 27.5% after CAS (p<0.001; OR 4.46; 95% CI 2.12–9.37). Although the number of antihypertensive medications decreased significantly in both groups (p<0.001), sustained BP control with reduced pharmacologic burden was observed only after CEA.

Conclusion. Both carotid revascularization strategies significantly reduce SBP within the first postoperative year. In the long term, CEA with carotid body excision provides a more durable antihypertensive effect and a higher likelihood of achieving target BP compared with CAS. These findings suggest that the type of intervention may influence peripheral baro- and chemoreflex mechanisms of blood pressure regulation and merit further investigation.

Background. In modern clinical practice thoracic endovascular aortic repair is the dominant treatment method for patients with diseases of the descending thoracic aorta. In patients with a shorter proximal neck, there is a need to implant the stent graft in Ishimaru zone 2, which involves covering the left subclavian artery. In modern practice, both surgical and endovascular techniques for LSA preservation are available.

Objective the aim of the study was to evaluate the efficacy and safety of endovascular aortic repair with coverage of the left subclavian artery using various preservation strategies.

Patients and methods. А retrospective analysis of 126 patients who underwent endovascular aortic repair with coverage of the left subclavian artery. Two groups were identified: Group 1 – 83 (65.9%) patients who underwent endovascular left subclavian artery preservation, including: «on-table» stent graft fenestration (Subgroup Ia) and in situ stent graft fenestration (Subgroup Ib); Group 2 – 43 (34.1%) patients who underwent carotid-subclavian bypass/transposition. A comparative analysis was conducted regarding technical success, left subclavian artery patency, complication and reintervention rates. For Subgroups Ia and Ib, a composite technical success endpoint was calculated, encompassing left subclavian artery patency, freedom from endoleaks, reinterventions, ischemic and vascular complications.

Results. Intraoperative technical success was achieved in 100% of patients. In-hospital stroke and mortality rates were 1 (1.2%) and 1 (2.3%) in Groups 1 and 2, respectively (p=0.633). Vascular complications were significantly more frequent in Group 2: 14.0 vs 2.4% (p=0.019). Two cases of retrograde aortic dissection were recorded in Group 1. Reintervention rates in Groups I and II were 4.8% and 7%, respectively (p=0.616). In the long-term follow-up, left subclavian artery patency was 100% in both Groups. In Group II, there was 1 (2.3%) case of graft occlusion requiring reintervention to restore blood flow through the left subclavian artery. Composite technical success was 98% and 84.4% in Subgroups Ia and Ib, respectively (p=0.030). Subgroup Ib showed longer operative time (mean difference 44.7 minutes, 95% CI 23.9–65.4) and fluoroscopy time (mean difference 10.9 minutes, 95% CI 3.8–18).

Conclusion. Preservation of the left subclavian artery is advisable during endovascular aortic repair with proximal landing in Ishimaru zone 2. The choice of a specific preservation method is determined by the patient’s clinical and anatomical characteristics. Endovascular techniques are a feasible and effective alternative to surgical methods of left subclavian artery preservation. The “on-table” fenestration technique may offer advantages in reducing the overall rate of complications and reinterventions compared with in situ fenestration.

Background. The least invasive method of surgical treatment and prevention of rupture of abdominal aortic aneurysms is abdominal aortic arthroplasty (Endovascular Aneurysm Repair, EVAR). However, despite all the advantages, this minimally invasive endovascular intervention does not demonstrate superiority over open prosthetics in the long term due to the occurrence of postoperative complications.

The aim of the study was to evaluate the immediate and long–term results of EVAR in order to form an algorithm for determining the volume of intervention that reduces the likelihood of postoperative complications.

Material and methods. From 2010 to 2025, 126 patients underwent EVAR in the departments of vascular surgery at the F.I. Inozemtsev State Clinical Hospital. The average age of the patients was 67.68±0.88 years. The average size of abdominal aortic aneurysms is 56.98±0.28 mm (median is 50 mm). Puncture access was used in 59.5% of patients, and open projection femoral access was used in 40.5%. The following endografts were identified: Endurant II – 60.32%, Ankura – 16.53%, Anaconda – 15.70%, Gore Excluder – 8.73%. The average duration of the operation was 136.43±0.37 (2 hours 16 minutes).

Results. The average bed-day is 6.41±0.26. A total of 26 (20.64%) complications were registered. Of these, 8 (6.4%) were in the first 30 days after surgery, while the remaining 18 (14.3%) were in the long-term postoperative period. Long-term results were estimated on average 3–4 years after surgery. Endolics were found most often (7.1%) (type I – 4.8%, type II – 2.4%). As a result, the cumulative 5-year survival rate was 83%.

Conclusion. EVAR is a promising minimally invasive intervention for aneurysms of the infrarenal abdominal aorta, through which it is possible to reduce the risk of significantly reducing the number of complications in the early postoperative period, hospital mortality and hospital stay. Long-term results also demonstrate acceptable effectiveness of this method and a fairly low incidence of complications. All patients after EVAR should undergo annual screening in the amount of multi-spiral computed tomography.

The aim is to evaluate the effectiveness of various operations during repeated interventions in patients with occlusion of the superficial femoral artery.

Material and methods. The results of treatment of 28 patients who underwent repeated reconstructive surgery for occlusion of the superficial femoral artery (SBA) were analyzed. The patients were divided into 2 groups: Group 1 – patients who underwent loop endarterectomy from the PBA and removal of the thrombosed femoral–popliteal shunt (n=12); Group 2 – patients who underwent repeated bypass surgery with an autovene or prosthesis (n=16).

Results. The median time from the moment of primary surgery to the second intervention was 16 months in group 1 and 17 months in group 2 (p=0.434). In group 1, no thrombosis, death, or other cardiovascular event was recorded in the early postoperative period. In group 2, in the early postoperative period, 1 patient developed prosthetic thrombosis again, and 1 more reconstructive operation was performed to form a distal anastomosis on the lower leg. There were also no major cardiovascular events or deaths in group 2.

Patency in the period of 12, 36, and 60 months was 92.6, 92.6, and 75% in group 1 (loop endarterectomy from PBA), respectively. In group 2 (repeated femoral-popliteal bypass surgery), bypass patency was 81.3, 68.8, and 62.5%, respectively (p=0.262). Freedom from amputation was 100, 100, and 91.7% in group 1 at 12, 36, and 60 months, and 81.3, 75, and 75% in those groups. the same time frame, respectively (p=0.114).

Conclusion. In case of thrombosis of the initially formed femoral-popliteal shunts, a loop endarterectomy from the superficial femoral artery may be recommended as a repeat operation, which is as effective as the method of repeated femoral-popliteal shunts.

The publication considers the problem of subjective symptoms in chronic venous diseases. The analysis of the international SYM Vein Consensus statement, as well as advisory documents with an emphasis on vein-specific symptoms is carried out. It is concluded that their vein specificity is often manifested not by the fact of ascertainment, but by the dependence of the severity of these symptoms on time characteristics. SYM Vein Consensus currently requires more serious analysis, validation and cannot currently serve as an absolute standard for clinical trials. There is an objective need to discuss the problem of venospecificity of subjective symptoms in chronic venous diseases at the level of professional communities.

Carotid artery stenting is an effective method for treating stenotic lesions of the carotid arteries and preventing stroke. However, despite continuous technological advancements in stents and neuroprotection systems, the procedure carries the risk of complications that can affect clinical outcomes.

This article provides a review of the literature on complications associated with carotid artery stenting, their classification, risk factors, clinical manifestations, prevention and management strategies, as well as the authors’ own experience in endovascular treatment of patients with stenotic carotid artery lesions at the Department of Endovascular Surgery and Invasive Cardiology of the “Central Clinical Hospital with Polyclinic” of the Administrative Directorate of the President of the Russian Federation.

Aim. To evaluate the effectiveness of femoro-femoral crossover bypass in high-risk patients with unilateral aorto-iliac occlusive disease.

Material and methods. A retrospective analysis was conducted on 26 patients (22 men, 4 women; mean age 67.8±7.4 years) who underwent femoro-femoral crossover bypass using a ring-reinforced PTFE graft at the National Scientific Center of Surgery named after A.N. Syzganovbetween 2017 and 2025. Graft patency, postoperative complications, mortality, and limb salvage were assessed during early and long-term follow-up.

Results. All operations were technically successful with restoration of distal blood flow in 100% of cases. Postoperative complications occurred in 2 patients (7.6%): one late graft infection and one in-hospital death (3.8%). The mean hospital stay was 14±5 days. At five-year follow-up (available in 9 patients), graft patency remained 100%, with complete limb salvage and no major reinterventions.

Conclusion. Femoro-femoral crossover bypass is a safe and reliable revascularization method for patients with aorto-iliac occlusive disease who are unsuitable for direct aortic reconstruction. The procedure provides excellent long-term patency, full limb salvage, and minimal morbidity and mortality.

The article presents clinical observations of surgical treatment of patients with infectious aneurysms of the aorta and iliac arteries. Initially, the patients sought medical help for pain in the lumbar region. The examination revealed aneurysms of various localization, accompanied by a syndrome of systemic inflammatory response. An open surgery was chosen as the treatment strategy. One patient required reintervation after the first operation due to the formation of a pseudoaneurysm of the distal anastomosis. Both patients were discharged for outpatient treatment after massive antibacterial therapy and normalization of their parameters.

Infection of the abdominal aortic endograft and synthetic shunt are life-threatening complications. Despite the development of modern methods of surgical treatment and antimicrobial therapy, the problem of infectious complications after aortic reconstructions using synthetic prostheses remains relevant. The search for optimal surgical approaches continues, including the use of biological materials such as homographs to replace infected structures.

The article presents a clinical case of successful surgical treatment of a patient with infected abdominal aortic endograft and a femoral-femoral synthetic bypass graft in a patient with advanced sepsis.

The patient, who was admitted in a state of sepsis with an infected abdominal aortic endograft and a synthetic femoral-femoral bypass graft, underwent abdominal aortic reprosthetics using a homograph.

It has been shown that a biological prosthesis can be implanted in the area of an infected synthetic prosthesis with a good postoperative result, even in conditions of sepsis. However, this approach requires highly qualified surgeons and careful planning. Additional research is needed to assess the long-term safety and effectiveness of using homographs.

If it is impossible to use autovens to replace an infected synthetic abdominal aortic prosthesis, it is possible to successfully use a homograph with mandatory dynamic monitoring in the near and long-term postoperative periods for early diagnosis of reinfection and aneurysmal transformation.

Objective. Conducting a meta-analysis to assess consistency between the indices of cerebral oxygenation (near infrared spectrometry, NIRS), clinical data, pressure in the stump, findings of transcranial Doppler ultrasonography, and neurosensory status of patients, as well as to determine optimal comprehensive criteria for making a decision on a temporary intravascular shunt during carotid endarterectomy under regional anesthesia.

Material and methods. A systematic search was carried out in databases PubMed, Medline and Cochrane Library over the period from January 2015 to October 2025. Inclusion criteria: prospective observational studies or randomized controlled studies with participation of patients subjected to carotid endarterectomy under regional anesthesia, assessing consistency of instrumental methods of monitoring and clinical picture. The statistical analysis was performed in the R program (version 4.2.1).

Results. The final analysis included 13 studies (1894 patients). The overall frequency of selective shunting amounted to 11.51% (95% confidence interval 10.11–13.03%). An optimal criterion for placement of a temporary shunt was a decrease of ΔrSO₂ ≥9–10% in combination with the appearance of neurological deficit (sensitivity 90–100% and specificity 70–83%). Multimodal methods of monitoring demonstrated the average AUC 0.90 vs 0.87 for double combinations. The perioperative stroke rate amounted to 1.48% (95% confidence interval 1.11–2.25%), thus corresponding to the modern international quality standards.

Conclusion. A combined approach with the use of NIRS-monitoring (threshold of ΔrSO₂ ≥9–10%) jointly with clinical assessment of the neurological status is an optimal criterion for selective shunting in carotid endarterectomy under regional anesthesia. Multimodality monitoring increases the diagnostic accuracy, making it possible to minimize the risk of ischemic complications.

In recent years, surgical interventions on the carotid arteries – such as carotid endarterectomy and stenting – have become key methods for preventing ischemic stroke. In addition to their proven clinical effectiveness, increasing attention is being paid to their influence on patients’ cognitive functions.

This review summarizes current data from both domestic and international studies on the dynamics of cognitive function following carotid revascularization. It discusses the primary mechanisms behind cognitive changes, including reperfusion injury, microembolism, and cerebral hyperperfusion syndrome. Particular attention is given to the comparative evaluation of endarterectomy and stenting in terms of long-term cognitive outcomes.

The review also outlines key risk factors for cognitive impairment and proposes strategies to reduce them. The findings underscore the importance of an individualized approach when selecting surgical tactics and emphasize the need for further research in this area.

Background. Percutaneous coronary intervention (PCI) is a minimally invasive procedure that is a well-established method for treating patients with coronary artery disease. The explosive growth in the number of PCI performed over the past decade, not only in Russia but worldwide, has inevitably led to an increase in the number of complications that specialists encounter in their daily practice. The significance of the problem of thrombotic complications during coronary artery stenting is difficult to overestimate. This review focuses on two of the most significant and actively studied complications – stent thrombosis and radial artery occlusion – as their minimization directly impacts long-term treatment outcomes.

Objective. To analyze data on the key risk factors, pathogenesis, and prevention strategies for stent thrombosis and radial artery occlusion in patients undergoing PCI.

Methods. A literature analysis was conducted using the PubMed, the Cochrane Library, and Google Scholar databases.

Results. The results of this study allow for a systematic assessment of the causes, predisposing conditions, and prevention methods for stent thrombosis and radial artery occlusion. For stent thrombosis, three main groups of risk factors were identified: procedural, patient-related, and pharmacological. For radial artery occlusion, predictors related to both the patient and the procedure were identified. The efficacy of intravascular imaging in reducing the incidence of stent thrombosis and the use of distal radial access in reducing the incidence of radial artery occlusion were demonstrated.

Conclusion. The problem of minimizing various thrombotic complications during coronary stenting remains highly relevant even against the background of improved PCI technologies, the introduction of modern tools and pharmacotherapy. A promising area is the development of validated prognostic models that integrate clinical, anatomical, and genetic factors.