Outpatient coronary angioplasty: Feasible and safe

• DOI: 10.1002/ccd.20313
• Publication Date: 2005-03-23T23:18:15Z
• Authors: Ton Slagboom; Ferdinand Kiemeneij; Gert Jan Laarman; Ron van der Wieken
• Keywords: Male; Cardiac Catheterization; Chi-Square Distribution; Cost-Benefit Analysis; Coronary Stenosis; Middle Aged; Coronary Angiography; Risk Assessment; 3. Good health; Femoral Artery; 03 medical and health sciences; Catheters, Indwelling; 0302 clinical medicine; Radial Artery; Ambulatory Care; Humans; Female; Angina, Unstable; Angioplasty, Balloon, Coronary; Safety; Aged; Follow-Up Studies; Probability

AbstractThis study tested the safety and feasibility of coronary angioplasty on an outpatient basis. The purpose of this approach includes cost‐effectiveness and patient comfort. Six hundred forty‐four patients were randomized to either transradial or transfemoral PTCA using 6 Fr equipment. Patients were triaged to outpatient management based on a predefined set of predictors of an adverse outcome in the first 24 hr after initially successful coronary angioplasty. Three hundred seventy‐five patients (58%) were discharged 4–6 hr after PTCA; 42% stayed in hospital overnight. In the outpatient group, one adverse event occurred (subacute stent thrombosis 7 hr postdischarge, nonfatal myocardial infarction). There were no major vascular complications. In the hospital group, 19 patients (7%) sustained an adverse cardiac even in the first 24 hr; 1 patient died. Patients treated via the femoral route had more (minor) bleeding complications (19 patients; 6%); in 17 of these, this was the sole reason that discharge was delayed. PTCA on an outpatient basis, performed via the radial or the femoral artery with low‐profile equipment, is safe and feasible in a considerable part of a routine PTCA population. A larger proportion of transradial patients can be discharged due to a reduction in (minor) bleeding complications. Catheter Cardiovasc Interv 2005;64:421–427. © 2005 Wiley‐Liss, Inc.