Outpatient percutaneous transluminal angioplasty: preconditions and results

The present study considers whether percutaneous transluminal angioplasty (PTA) using a balloon catheter may also be performed on an outpatient basis. The prerequisites for the choice of an out-patient procedure were location of the flow obstruction above the knee joint, exclusive catheter recanalisation, absence of any complications during and after the intervention, radiological and vascular surgical standby, patient compliance and adequate social environment. In our 36 patients, 12 PTAs were performed in the pelvic region, 23 in the area of the femoral artery and one in the area of the popliteal artery. The primary success rate in the pelvic region was 100%, that in the femoropopliteal region 91.7%. The cumulative patency rate after an average follow-up period of 4 months was 89% (one early recurrence within 24 hours, 2 late recurrences after 3 and 5 months, respectively). In order to prevent early recurrence, thrombocyte aggregation inhibitors were given in combination with heparin at standard dosage. Two patients had to be hospitalized for monitoring after an aspiration embolectomy in the one case and a major haematoma in the other case. The advantages of a PTA intervention performed on an out-patient basis were the reduced time lag between diagnosis and therapy, full mobility of the patient and minimisation of hospitalization costs. Our results justify the choice of an outpatient schedule for the performance of balloon catheter recanalization in a carefully selected patient population.