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Ambulatory transradial percutaneous coronary intervention: A safe, effective, and cost-saving strategy.: Ambulatory PCI: a safe and effective strategy

Abstract : Objectives: The aim of this prospective, multicenter study was to assess the safety, feasibility, acceptance, and cost of ambulatory transradial percutaneous coronary intervention (PCI) under the conditions of everyday practice. Background: Major advances in PCI techniques have considerably reduced the incidence of post-procedure complications. However, overnight admission still constitutes the standard of care in most interventional cardiology centers. Methods: Eligibility for ambulatory management was assessed in 370 patients with stable angina referred to three high-volume angioplasty centers. On the basis of pre-specified clinical and PCI-linked criteria, 220 patients were selected for ambulatory PCI. Results: The study population included a substantial proportion of patients with complex procedures: 115 (52.3%) patients with multivessel coronary artery disease, 50 (22.7%) patients with multilesion procedures, and 60 (21.5%) bifurcation lesions. After 4-6 hr observation period, 213 of the 220 patients (96.8%) were cleared for discharge. The remaining seven (3.2%) patients were kept overnight for unstable angina (n = 1), atypical chest discomfort (n = 2), puncture site hematoma (n = 1), or non-cardiovascular reasons (n = 3). Within 24 hr after discharge, no patients experienced readmission, stent occlusion, recurrent ischemia, or local complications. Furthermore, 99% of patients were satisfied with ambulatory management and 85% reported no anxiety. The average non-procedural cost was lower for ambulatory PCI than conventional PCI (1,230 ± 98 Euros vs. 2,304 ± 1814 Euros, P < 10(-6) ). Conclusions: Ambulatory PCI in patients with stable coronary artery disease is safe, effective, and well accepted by the patients. It may both significantly reduce costs and optimize hospital resource utilization. © 2012 Wiley Periodicals, Inc.
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Submitted on : Wednesday, October 30, 2013 - 2:18:35 PM
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Philippe Le Corvoisier, Barnabas Gellen, Pierre-François Lesault, Remy Cohen, Stéphane Champagne, et al.. Ambulatory transradial percutaneous coronary intervention: A safe, effective, and cost-saving strategy.: Ambulatory PCI: a safe and effective strategy. Catheterization and Cardiovascular Interventions, Wiley, 2013, 81 (1), pp.15-23. ⟨10.1002/ccd.24545⟩. ⟨inserm-00784216⟩

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