Same-day-discharge ad hoc percutaneous coronary intervention: Initial single-centre experience

Summary Background Progress in techniques and equipment facilitates same-day-discharge percutaneous coronary intervention (PCI). Aim To present initial experience of a same-day-discharge intention-to-treat ad hoc PCI strategy with a preferentially radial approach. Methods The first 102 same-day-disc...

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Bibliographic Details
Published in:Archives of cardiovascular diseases 2009-11, Vol.102 (11), p.743-748
Main Authors: Perret, Xavier, Bergerot, Cyrille, Rioufol, Gilles, Bonvini, Robert-Francis, Ovize, Michel, Finet, Gérard
Format: Article
Language:English
Subjects:
Aged
Ambulatoire
Angioplastie coronaire
Angioplasty
Angioplasty, Balloon, Coronary - adverse effects
Angioplasty, Balloon, Coronary - methods
Angioplasty, Balloon, Coronary - psychology
Anxiety - etiology
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Blood Coagulation Tests
Cardiologie interventionnelle
Cardiology. Vascular system
Cardiovascular
Coronary Angiography
Coronary Disease - diagnostic imaging
Coronary Disease - therapy
Diseases of the cardiovascular system
Electrocardiography
Female
France
Humans
Internal Medicine
Length of Stay
Male
Medical sciences
Middle Aged
Monitoring, Physiologic - methods
Patient Discharge
Patient Satisfaction
Percutaneous coronary intervention
Pilot Projects
Radial access
Radial Artery
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Retrospective Studies
Revascularization
Risk Assessment
Severity of Illness Index
Surveys and Questionnaires
Time Factors
Treatment Outcome
Voie radiale
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Summary:Summary Background Progress in techniques and equipment facilitates same-day-discharge percutaneous coronary intervention (PCI). Aim To present initial experience of a same-day-discharge intention-to-treat ad hoc PCI strategy with a preferentially radial approach. Methods The first 102 same-day-discharge PCIs performed in our centre were analysed retrospectively. Subjects were stable or stabilised coronary patients, free of cardiac insufficiency, with a normal Allen test and residing within 60 min of the centre. Discharge was authorised after six hours’ event-free monitoring. The principal assessment criterion combined major adverse cardiovascular events, stroke, major haemorrhage and unscheduled medical consultation in the 30 days following PCI. Overall patient satisfaction and anxiety associated with same-day discharge were assessed by telephone questionnaire at some time after the intervention. Results Between January 2006 and March 2008, 95 day-hospital patients underwent 102 distinct PCIs (50 complex, 13 bifurcation lesions, nine intravascular ultrasound, 18 fractional flow reserve, two Rotablator procedures). Crossover to overnight admission was necessary for 5.9% ( n = 6) of interventions. Baseline clinical and angiographic characteristics were similar to those of an unselected Western population. At 30 days, four clinical events were observed (3.9% of interventions), which occurred within 6 hours ( n = 2) or after the 24th hour. Classical 24-hour admission would thus have provided no added benefit. On an analogue scale, overall satisfaction was high (8.9/10) and anxiety associated with same-day discharge was low (1.7/10). Conclusion A same-day-discharge ad hoc PCI strategy proved reliable and safe for most patients selected a priori on simple clinical criteria, entailing no unexpected complications due to shorter medical monitoring.
ISSN:1875-2136
1875-2128
DOI:10.1016/j.acvd.2009.09.002