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[Efficacy and safety of ambulatory coronary angiography]
X Favereau1, T Corcos, G Souffrant
1Département de cardiologie, centre médico-chirurgical Parly-Grand Chesnay.
Insights
Ambulatory coronary arteriography is a safe and effective outpatient procedure for stable patients. This minimally invasive diagnostic technique offers economic benefits and could be widely adopted.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Imaging
Context:
- Ambulatory coronary arteriography, a diagnostic procedure for coronary artery disease, is increasingly being explored as an outpatient alternative to inpatient settings.
- This study evaluates the feasibility and outcomes of ambulatory coronary arteriography within the initial 18 months of a department's operation.
Purpose:
- To assess the safety, efficacy, and economic viability of performing coronary arteriography on an outpatient basis.
- To determine patient selection criteria, procedural protocol, and complication rates for ambulatory coronary arteriography.
Summary:
- A total of 160 patients underwent ambulatory coronary arteriography, with selection based on stable clinical condition.
- The protocol included day hospital admission, no routine anticoagulation, use of 5 French catheters, mobilization at 4 hours, and discharge at 6 hours post-procedure.
- Coronary artery disease was diagnosed in 55% of patients, with minor complications in 2% and 8 patients requiring full admission due to lesion severity.
Impact:
- Ambulatory coronary arteriography demonstrates a favorable safety profile, effectiveness, and economic advantages.
- The findings suggest that this outpatient approach can be safely expanded with adherence to contraindications, potentially improving healthcare resource utilization.
Abstract:
Ambulatory coronary arteriography was carried out in 160 patients in the first 18 months' activity of our department (9.5% of all cardiac catheterisations and 16% of all coronary arteriographies during the same period). An absolutely stable clinical condition was the main criterion of selection for this investigation and the protocol consisted in day hospital admission, absence of routine anticoagulation, small calibre (5 French = 1.7 mm) catheters, mobilisation 4 hours and discharge 6 hours after the procedure. The patients were 38 women and 122 men whose average age was 55 years. The percutaneous femoral approach was used in most cases (95%). Single or multiple coronary artery disease was documented in 55 per cent of these patients: there were 2 cases of left main stem stenosis. Eight patients required full hospital admission, mainly because of the severity of the coronary lesions. Minor complications occurred in 2 per cent of cases. These results indicate that ambulatory coronary arteriography is safe, effective and economic. It could be used more extensively always providing that the contra-indications are respected.