Abstract
Objectives: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. Background: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. Methods: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital. Results: Of the 1190 PCIs, 166 (13.9%) were complex (bifurcations, vein and arterial grafts, unprotected left main, last remaining vessel, chronic total occlusions, or with utilization of rotational atherectomy or hemodynamic support). As compared with non-complex cases, complex cases were associated with older age, male gender, higher prevalence of diabetes mellitus and prior coronary artery bypass graft surgery, lower prevalence of smoking, higher utilization of femoral access and 7F guiding catheters, higher contrast utilization and fluoroscopy dose, longer fluoroscopy time, more stents per lesion, more frequent single vessel treatment and non-complete revascularization, and treatment with ticagrelor and bivalirudin. Among the patients who underwent complex PCI (n = 166), twenty eight (16.9%) were discharged the same day. SDD after complex PCI was associated with younger age and more frequent use of forearm access. The 30-day incidence of major adverse cardiac events after complex PCI was 0% vs 3.6% (p = 0.59) in patients with SDD vs. overnight hospitalization. Conclusions: SDD is feasible and safe in selected patients undergoing elective complex PCI using the forearm approach.
| Original language | English (US) |
|---|---|
| Journal | Cardiovascular Revascularization Medicine |
| DOIs | |
| State | Accepted/In press - Jan 14 2017 |
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Keywords
- Complex
- Complications
- Outcomes
- Percutaneous coronary intervention
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Feasibility and safety of same-day discharge after complex percutaneous coronary intervention using forearm approach. / Koutouzis, Michael; Karatasakis, Aris; Brilakis, Emmanouil S.; Agelaki, Maria; Maniotis, Christos; Dimitriou, Panagiotis; Lazaris, Efstathios.
In: Cardiovascular Revascularization Medicine, 14.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Feasibility and safety of same-day discharge after complex percutaneous coronary intervention using forearm approach
AU - Koutouzis, Michael
AU - Karatasakis, Aris
AU - Brilakis, Emmanouil S.
AU - Agelaki, Maria
AU - Maniotis, Christos
AU - Dimitriou, Panagiotis
AU - Lazaris, Efstathios
PY - 2017/1/14
Y1 - 2017/1/14
N2 - Objectives: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. Background: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. Methods: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital. Results: Of the 1190 PCIs, 166 (13.9%) were complex (bifurcations, vein and arterial grafts, unprotected left main, last remaining vessel, chronic total occlusions, or with utilization of rotational atherectomy or hemodynamic support). As compared with non-complex cases, complex cases were associated with older age, male gender, higher prevalence of diabetes mellitus and prior coronary artery bypass graft surgery, lower prevalence of smoking, higher utilization of femoral access and 7F guiding catheters, higher contrast utilization and fluoroscopy dose, longer fluoroscopy time, more stents per lesion, more frequent single vessel treatment and non-complete revascularization, and treatment with ticagrelor and bivalirudin. Among the patients who underwent complex PCI (n = 166), twenty eight (16.9%) were discharged the same day. SDD after complex PCI was associated with younger age and more frequent use of forearm access. The 30-day incidence of major adverse cardiac events after complex PCI was 0% vs 3.6% (p = 0.59) in patients with SDD vs. overnight hospitalization. Conclusions: SDD is feasible and safe in selected patients undergoing elective complex PCI using the forearm approach.
AB - Objectives: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. Background: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. Methods: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital. Results: Of the 1190 PCIs, 166 (13.9%) were complex (bifurcations, vein and arterial grafts, unprotected left main, last remaining vessel, chronic total occlusions, or with utilization of rotational atherectomy or hemodynamic support). As compared with non-complex cases, complex cases were associated with older age, male gender, higher prevalence of diabetes mellitus and prior coronary artery bypass graft surgery, lower prevalence of smoking, higher utilization of femoral access and 7F guiding catheters, higher contrast utilization and fluoroscopy dose, longer fluoroscopy time, more stents per lesion, more frequent single vessel treatment and non-complete revascularization, and treatment with ticagrelor and bivalirudin. Among the patients who underwent complex PCI (n = 166), twenty eight (16.9%) were discharged the same day. SDD after complex PCI was associated with younger age and more frequent use of forearm access. The 30-day incidence of major adverse cardiac events after complex PCI was 0% vs 3.6% (p = 0.59) in patients with SDD vs. overnight hospitalization. Conclusions: SDD is feasible and safe in selected patients undergoing elective complex PCI using the forearm approach.
KW - Complex
KW - Complications
KW - Outcomes
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85012877261&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85012877261&partnerID=8YFLogxK
U2 - 10.1016/j.carrev.2017.02.001
DO - 10.1016/j.carrev.2017.02.001
M3 - Article
C2 - 28214141
AN - SCOPUS:85012877261
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
SN - 1553-8389
ER -