title: Same-Day Discharge After Treatment with the Pipeline Embolization Device Using Monitored Anesthesia Care.
abstract: OBJECTIVE
  The Pipeline Embolization Device (PED) has been used and shown to be safe under monitored anesthesia care (MAC). We present the results of the first study, to our knowledge, assessing the safety and feasibility of same-day discharge in patients undergoing treatment with the PED, using MAC.
  
  
  METHODS
  A total of 130 patients with 143 cerebral aneurysms (CAs) were identified. Patients were treated under MAC with the PED. All of the patients were counseled preoperatively about the elective nature of the procedure and the same-day discharge.
  
  
  RESULTS
  The mean age of the participants was 60.7 ± 12.12 years. Men constituted 27.69% (36/130) of the population. The number of procedures was 138. All of our patients elected to return home the same day, whereas only 6.15% (8/130) of them changed their mind in the postoperative setting and elected to stay overnight out of convenience (late discharge, patient preference, or living alone at home). Overall discharge home on the same day occurred after 90.6% of procedures (125/138) and in 91.53% (119/130) of the patients. All same-day discharges took place within 4-6 hours after the procedures. The rate of major complications was 0.75% (1/134). The mortality rate was 0%.
  
  
  CONCLUSIONS
  PED treatment under MAC is feasible and safe. This has brought forth an era of outpatient treatment of CAs where patients are discharged home 6 hours after the procedure.
authors: Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA.
authors: Mario
authors: M
authors: Zanaty
authors: Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors: Badih
authors: B
authors: Daou
authors: Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors: Nohra
authors: N
authors: Chalouhi
authors: Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
authors: Robert M
authors: RM
authors: Starke
authors: Department of Neurology and Interventional Radiology, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA.
authors: Edgar
authors: E
authors: Samaniego
authors: Department of Radiology and Interventional Radiology, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA.
authors: Colin
authors: C
authors: Derdeyn
authors: Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
authors: Pascal
authors: P
authors: Jabbour
authors: Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA. Electronic address: david-hasan@uiowa.edu.
authors: David
authors: D
authors: Hasan
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002533:Cerebral Angiography; D054810:Deep Sedation / Q000379:methods*; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods*
keywords: Aneurysm; Coiling; Flow diversion; Interventional; Outcome; Pipeline; Same-day discharge; Stenting