Endovascular interventions in outpatient care

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Public Health

Background:

• Peripheral arterial disease (PAD) treatment is growing due to an aging population and high comorbidity rates in Germany.
• Patients with PAD face significant risks of cardiovascular complications during and after endovascular revascularization.
• Increasing resource limitations and hospitalization risks drive the shift towards day-case procedures for PAD.

Purpose of the Study:

• To summarize requirements and risk factors for planning, performing, and managing outpatient endovascular revascularizations for PAD.
• To provide guidance for the safe execution of day-case endovascular procedures in patients with symptomatic PAD.
• To advocate for a standardized quality assurance process for all endovascular revascularizations.

Main Methods:

• Position paper development by the German Society of Angiology, endorsed by the European Society of Vascular Medicine.
• Review of current practices and risk factors associated with endovascular revascularization for PAD.
• Synthesis of recommendations for outpatient management, including pre-procedural planning, procedural conduct, and post-procedural care.

Main Results:

• Endovascular revascularization for PAD is increasingly performed on an outpatient basis, with over a third done by specialized internists in Germany.
• Key considerations for outpatient procedures include patient selection, risk assessment, procedural planning, and comprehensive post-procedural care.
• A mandatory quality assurance process is crucial for tracking procedural data, complications, and long-term outcomes.

Conclusions:

• Outpatient endovascular revascularization for PAD is a viable and growing alternative to inpatient care, provided stringent safety and quality measures are met.
• Standardized protocols and robust quality assurance are essential to ensure patient safety and optimize outcomes for day-case PAD treatments.
• The position paper provides a framework for the safe and effective implementation of outpatient endovascular revascularization, supported by leading European vascular medicine societies.