Outpatient vascular intervention: a two-year experience.
OBJECTIVE
To retrospectively analyze the outcome of a range of interventional vascular procedures performed on outpatients.


METHODS
Suitability for outpatient procedures was assessed according to agreed protocols. An episode was defined as any procedure/s through a single access site at one attendance. Retrospective case-note review was performed.


RESULTS
There were 693 outpatient episodes between April 1998 and May 2000 (290 interventional, and 403 diagnostic procedures), comprising 25% (693/2,769) of the total workload. Follow-up is available in 214; 38 of these were transfers from outlying hospitals and were excluded from analysis. One hundred and seventy-six were true outpatients. There were 98 iliac and 46 femoropopliteal interventions, 2 aortic stents, 1 renal and 5 upper-limb angioplasties (PTAs), 5 embolizations, 8 Hickman lines, 1 line stripping, 3 atherectomies, 1 dialysis-graft PTA and 6 bypass-graft PTAs. Sixty-eight closure devices were used. Twelve patients were converted to inpatients (6.8%, 12/176). The readmission rate was 3.4% (6/176). The reattendance rate was 1.1% (2/176), both subsequently attending for outpatient duplex ultrasound examination to exclude pseudoaneurysm. The major complication rate was 3.4% and the delayed major complication rate was 1.7%.


CONCLUSIONS
Outpatient vascular intervention is safe with appropriate protocols and with careful patient selection. Local vascular services benefit from the release of inpatient beds.
Macdonald
Sumaira
S
Sheffield Vascular Institute, Firth 4, Northern General Hospital, Herries Road, Sheffield S7 5AU, UK. sumaira@primedia.co.uk
Thomas
Steven M
SM
Cleveland
Trevor J
TJ
Gaines
Peter A
PA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D017073:Atherectomy / Q000009:adverse effects; D015331:Cohort Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects*