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


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%).


CONCLUSIONS
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.
Clément-Major
Sébastien
S
Faculty of Medicine, Division of Cardiology, Centre Hospitalier de l'Université de Montréal, University of Montréal, Québec.
Lemire
François
F
D000553:Ambulatory Care / Q000379:methods*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D017534:Radial Artery / Q000601:surgery; D012017:Referral and Consultation; D012189:Retrospective Studies; D012449:Safety; D015607:Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome