Document Detail


Feasibility of outpatient coronary angiography with "ad hoc" angioplasty.
MedLine Citation:
PMID:  18809151     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the feasibility and safety of coronary angiography combined, where necessary, with ad hoc angioplasty in an outpatient setting; a prospective, single-center study. The first 172 patients (154 men, 59 +/- 11 years) considered at low risk for complications were enrolled for outpatient-coronary angiography with or without angioplasty via a radial approach. The inclusion criteria were clinical, not based on angiography. After angiography/angioplasty, creatinine and troponin were assayed (outside the hospital) within 24h and patients were telephoned and asked about their clinical condition. Angioplasty was performed in 69 (40%) patients and 130 patients (75.6%) were discharged on the same day. In the angioplasty group, a history of coronary dilatation was more common in patients discharged on the same day (p = 0.05), whereas bifurcation lesions were more frequent in subjects who were kept in hospital (p < 0.0001). No serious complications occurred during the study. Of the 42/172 prolonged hospitalizations, eight were due to minor procedural complications, five due to failure of the radial route and three for indications for bypass surgery; the others were kept in for reasons unrelated to a complication (e.g., the examination was performed late in the day, a particularly complex procedure, etc.). Four (3%) of the 24-hour telephone calls led to a visit, but not hospital admission. Overall, performing angiography and "ad hoc" angioplasty in the course of a single outpatient visit makes it possible to foreshorten the hospital stay and increase patient throughput with a given hospital capacity and, this, without increasing clinical risk. Exactly how these patients are selected remains to be defined and may certainly be improved compared to this initial experiment. An outpatient-coronary angiography and ad hoc angioplasty strategy is a viable option with a low risk for patients selected on the basis of simple clinical criteria. It combines the advantages of increased convenience for the patient and lower costs.
Authors:
Arnaud Chaumeil; Farzin Beygui; Jean-Philippe Collet; Laurent Payot; Rémi Choussat; Gérard Drobinski; Claude Le Feuvre; Gérard Helft; Daniel Thomas; Michel Komajda; Gilles Montalescot
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-08-15
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  101     ISSN:  1875-2136     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-09-23     Completed Date:  2008-12-18     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  383-90     Citation Subset:  IM    
Affiliation:
Institute of Cardiology, Pitié-Salpêtrière Hospital Group, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Ambulatory Care* / economics,  methods
Angioplasty, Balloon, Coronary / adverse effects,  economics,  methods*
Coronary Angiography / adverse effects,  economics,  methods*
Coronary Stenosis / diagnosis,  economics,  therapy*
Cost-Benefit Analysis / economics
Female
Hospitalization / economics
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Outpatients
Prospective Studies
Radial Artery
Risk Factors
Treatment Outcome
Comments/Corrections
Comment In:
Arch Cardiovasc Dis. 2008 Jun;101(6):381-2   [PMID:  18809150 ]

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