title: Management of ambulatory (day case) endovascular procedures for peripheral arterial disease.
abstract: BACKGROUND
  Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature.
  
  
  METHODS
  We used PRISMA guidelines and Medline to conduct this systematic review. 448 relevant articles were found. Twelve articles, all published after year 2000 were included and reviewed by two independent investigators.
  
  
  RESULTS
  Among 12 selected articles, 10762 outpatient endovascular procedures were performed and 3883 procedures were realized for arterial lower limb revascularization. Average age was 65.2. Major exclusion criteria were social isolation (no available accompanying adult for the first 24 hours, no available communication system) and high-risk patients (ASA 4 and above). During the perioperative period, no death was noted. Major hematoma rate was 0% to 3%, minor hematoma rate went from 1.6% to 20%. Conversion to in-patient status for overnight observation occurred in 0% to 16% in ten real life studies and was mostly due to complications at puncture site. Reintervention over the first month occurred in 0% to 4%. Readmission in the first month after being discharged occurred in 0% to 3.2%. Diabetes and critical limb ischemia were not related to higher complication rate.
  
  
  CONCLUSIONS
  This review indicates that outpatient endovascular procedures for PAD are safe and efficient. Guidelines are necessary to enforce patients' selection and insure high quality perioperative care.
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hauguel
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France.|Sarcomes Osseux et Remodelage des Tissus Calcifiés, Laboratoire Inserm UHR-S 1238, Nantes, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Maurel
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bague
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France.
authors.forename: Flora
authors.initials: F
authors.lastname: Gouaillier-Vulcain
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Costargent
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chaillou
authors.affiliation: Service of Vascular Surgery, Thoracic Institute, CHU Nantes, Nantes, France - yann.goueffic@chu-nantes.fr.|Sarcomes Osseux et Remodelage des Tissus Calcifiés, Laboratoire Inserm UHR-S 1238, Nantes, France.|University of Nantes, Nantes, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Gouëffic
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D011677:Punctures; D019233:Retreatment; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome