Outpatient endovascular intervention: is it safe?
OBJECTIVE
To evaluate the feasibility and safety of outpatient percutaneous endovascular intervention in the treatment of arterial occlusive disease.


METHODS
The records of 134 patients who underwent 151 outpatient endovascular procedures between 1992 and 1997 were reviewed retrospectively. According to established protocol, focal lower limb (n = 145) and subclavian (n = 6) arterial lesions requiring relatively straightforward endoluminal interventions were appropriate for outpatient management provided the patients were free of significant comorbidities. A percutaneous transfemoral approach was used for lower limb lesions, while subclavian angioplasty was performed via a brachial access. Heparin anticoagulation was administered conservatively. Patients were discharged 3 hours after sheath removal.


RESULTS
The majority (98%) of patients were discharged as planned. Three (2%) patients were observed overnight in the hospital for treatment of acute iliac artery thrombosis, puncture-site bleeding, and suboptimal angioplasty. No patient required hospitalization following discharge. Periprocedural morbidity was confined to 2 (1.5%) groin hematomas and 1 (0.7%) femoral pseudoaneurysm.


CONCLUSIONS
Outpatient endovascular intervention appears safe; however, proper case selection and technical excellence are inseparable components for the success of this strategy.
Division of Vascular Surgery, The Union Memorial Hospital, Baltimore, Maryland, USA. frankc@helix.org
F J
FJ
Criado
O
O
Abdul-Khoudoud
M
M
Twena
N S
NS
Clark
P
P
Patten
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D000792:Angiography; D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D012189:Retrospective Studies; D012449:Safety; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery; D016896:Treatment Outcome