Outpatient coronary stenting: femoral approach with vascular sealing.
Miniaturized devices and pressures for increased patient convenience and lowered cost have shortened length of stay for coronary interventions. A cohort of 60 patients was recruited to assess the feasibility of outpatient stenting with vascular sealing. Patients with stable and unstable angina or myocardial infarction > 24 hours were considered for this strategy. Mean time to hemostasis, ambulation and discharge were 6.1, 256 and 296 minutes, respectively, for the 6F group, and 11.0, 351 and 489 minutes for the 7 to 8F group. No acute procedural complications occurred, and there were no ischemic complications at 24 hours or 1 month. There was 1 pseudoaneurysm requiring surgical correction, but no other access site requiring treatment. The cost saved using the 6F approach is estimated at $478 and using the 8F approach, $437. Outpatient stenting using vascular sealing is feasible and safe, and may lead to significant nationwide cost reductions in the range of $40,000,000 yearly.
Wilentz
J R
JR
Beth Israel Medical Center, New York, NY, USA. jwilentz@att.net
Mishkel
G
G
McDermott
D
D
Ravi
K
K
Fox
J T
JT
Reimers
C D
CD
Maydick
S
S
D000553:Ambulatory Care; D015906:Angioplasty, Balloon, Coronary / Q000191:economics / Q000295:instrumentation*; D002404:Catheterization; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005263:Femoral Artery; D006489:Hemostatic Techniques / Q000191:economics / Q000295:instrumentation*; D006801:Humans; D010865:Pilot Projects; D015607:Stents / Q000191:economics; D013997:Time Factors