title: Treatment outcomes and lessons learned from 5134 cases of outpatient office-based endovascular procedures in a vascular surgical practice.
abstract: Introduction The office-based endovascular facility has increased in number recently due in part to expedient patient experience. This study analyzed treatment outcomes of procedures performed in our office-based endovascular suite. Methods Treatment outcomes of 5134 consecutive procedures performed in our office-based endovascular suites from 2006 to 2013 were analyzed. Five sequential groups (group I-V) of 1000 consecutive interventions were compared with regard to technical success and treatment outcomes. Results Our patients included 2856 (56%) females and 2267 (44%) males. Procedures performed included diagnostic arteriogram, arterial interventions, venous interventions, dialysis access interventions, and venous catheter management, which were 1024 (19.9%), 1568 (30.6%), and 3073 (60.0%), 621(12.1%), and 354 (6.9%), respectively. The complication rates for group I, II, III, IV, and V were 3%, 1.5%, 1%, 1.1%, and 0.7%, respectively. The complication rate was higher in group I when compared to each of the remaining four groups ( p < 0.05). Nine patients (0.18%) died within the 30-day period following their procedures, and none were procedure related. Conclusions Endovascular procedure can be performed safely in an office-based facility with excellent outcomes. Lessons learned in establishing office-based endovascular suites with efforts to reduce procedural complications and optimize quality patient care are discussed.
authors.affiliation: 1 Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, USA.|2 University Vascular Associates, Los Angeles, CA, USA.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lin
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.|4 DFW Vascular Group, Dallas, TX, USA.
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Yang
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Kollmeyer
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Pablo V
authors.initials: PV
authors.lastname: Uceda
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Ferrara
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Feldtman
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Joseph
authors.initials: J
authors.lastname: Caruso
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Karen
authors.initials: K
authors.lastname: Mcquade
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Jasmine L
authors.initials: JL
authors.lastname: Richmond
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Cameron E
authors.initials: CE
authors.lastname: Kliner
authors.affiliation: 3 Division of Vascular Surgery, Department of Surgery, Sanggye Paik Hospital, College of Medicine Inje University, Republic of Korea.
authors.forename: Kaitlyn E
authors.initials: KE
authors.lastname: Egan
authors.affiliation: 2 University Vascular Associates, Los Angeles, CA, USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Kim
authors.affiliation: 2 University Vascular Associates, Los Angeles, CA, USA.
authors.forename: Marius
authors.initials: M
authors.lastname: Saines
authors.affiliation: 2 University Vascular Associates, Los Angeles, CA, USA.
authors.forename: Rhoda
authors.initials: R
authors.lastname: Leichter
authors.affiliation: 2 University Vascular Associates, Los Angeles, CA, USA.|4 DFW Vascular Group, Dallas, TX, USA.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects; D000792:Angiography / Q000009:adverse effects; D002405:Catheterization, Central Venous; D003956:Dialysis; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D061214:Patient Safety; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D017064:Process Assessment, Health Care; D015641:Radiography, Interventional / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult
keywords: Outpatient; accreditation; ambulatory surgery; endovascular; fluoroscopy; patient safety