Is outpatient coronary angioplasty and stenting feasible and safe? Results of a retrospective analysis.

摘要

OBJECTIVE: To assess the safety of coronary angioplasty with or without stenting and with same day discharge in a population of outpatients or referred patients. This study also assessed the changing practice in the access route and the increasing use of stents. METHODS AND RESULTS: In this retrospective and descriptive study, the authors reviewed the files of ambulatory or referred patients hospitalized within seven days of a heart catheterization with coronary angiography between January 1997 and December 1999. Overall, 1856 patients were included, of which 546 (29.4%) had a coronary angioplasty. In the first six months, stents were used in 13.3% of outpatients and 23.5% of referred patients, while in the last six months 75.0% of outpatients and 73.0% of referred patients were stented. A total of 156 patients were triaged for a prolonged observation period of which 66 (12.1%) received some treatment (heparin, abciximab, coronary artery bypass graft or transfusion). Two patients (0.4%) had acute thrombosis. No patients experienced complications that could have been prevented by a one or two day routine observation period. While 47% of patients were accessed by the radial artery in the first six months, 77.2% of patients were accessed by the radial artery in the last six months. Significant access complications occurred in 11 patients (0.6%). CONCLUSION: Outpatient angioplasty is feasible and, according to the retrospective analysis of the authors' admittedly incomplete data, safe. The use of stents facilitates same-day discharge. Pre-, per- and postprocedural triage allows identification of high risk patients for a longer observation period with or without additional treatment.