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Outpatient endovascular intervention: is it safe?

F J Criado1, O Abdul-Khoudoud, M Twena

  • 1Division of Vascular Surgery, The Union Memorial Hospital, Baltimore, Maryland, USA. frankc@helix.org

Journal of Endovascular Surgery : the Official Journal of the International Society for Endovascular Surgery
|October 7, 1998
PubMed
Summary

This study evaluated the safety of outpatient endovascular procedures for treating arterial occlusive disease. A total of 151 procedures were performed on 134 patients between 1992 and 1997. The procedures focused on focal lower limb and subclavian artery lesions in patients without major health issues. Most patients were discharged within three hours of the procedure. Three patients required overnight observation due to complications like bleeding or suboptimal results. No long-term hospitalizations occurred. The complication rate was low, with two groin hematomas and one femoral pseudoaneurysm reported. The researchers suggest that outpatient procedures may be safe when performed with proper case selection and technical skill. They emphasize the importance of following strict protocols to ensure success.

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Area of Science:

  • Vascular surgery techniques
  • Endovascular intervention outcomes

Background:

Arterial occlusive disease remains a significant clinical challenge. While inpatient endovascular procedures are common, limited data exist on outpatient alternatives. Prior research has shown that endovascular techniques can be effective for arterial lesions. However, concerns remain about safety in non-hospital settings. No prior work had resolved whether outpatient care could match inpatient outcomes. This gap motivated a retrospective analysis of outpatient interventions. The study aimed to clarify if such procedures could be safely performed. It focused on lower limb and subclavian artery interventions specifically.

Purpose Of The Study:

The study aimed to assess the safety and feasibility of outpatient endovascular treatment for arterial occlusive disease. It targeted patients with focal lower limb or subclavian lesions. The researchers wanted to determine if these procedures could be done safely outside of inpatient settings. They focused on patients without major comorbidities. The goal was to evaluate if short-term outpatient care was viable. The team also wanted to identify risk factors for complications. They used a retrospective design to analyze historical data. The study emphasized the importance of case selection and technique.

Keywords:
endovascular proceduresoutpatient treatmentarterial diseasevascular surgery

Frequently Asked Questions

Ninety-eight percent of patients were discharged as planned, with no long-term hospitalizations.

The procedures targeted focal lower limb and subclavian artery lesions.

A transfemoral approach was used for lower limb lesions as per established protocol.

Heparin was administered conservatively for anticoagulation during the procedures.

The most common complications were groin hematomas and femoral pseudoaneurysms.

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Main Methods:

The researchers reviewed 151 outpatient endovascular procedures from 134 patients. The procedures occurred between 1992 and 1997. They focused on focal lower limb and subclavian artery lesions. Patients had to be free of significant comorbidities. A transfemoral approach was used for lower limb cases. Subclavian angioplasty used a brachial access. Heparin was administered conservatively for anticoagulation. Patients were discharged three hours after sheath removal.

Main Results:

Ninety-eight percent of patients were discharged as planned. Three patients required overnight observation for complications. These included acute iliac artery thrombosis, puncture-site bleeding, and suboptimal angioplasty. No patient needed hospitalization after discharge. Periprocedural complications included two groin hematomas and one femoral pseudoaneurysm. The overall complication rate was 2.2%. The majority of cases were completed without incident. The findings suggest that outpatient procedures can be safe when properly managed.

Conclusions:

The study suggests that outpatient endovascular intervention may be safe for selected patients. Proper case selection and technical skill are crucial for success. The complication rate was low, with no long-term hospitalizations. The researchers propose that this approach could reduce healthcare costs. They emphasize the importance of patient eligibility criteria. Technical excellence remains a key factor in outcomes. The findings do not suggest universal applicability. They highlight the need for strict adherence to protocols.

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The researchers propose that proper case selection and technical excellence are essential for success.