Contemporary outpatient percutaneous coronary intervention: feasible and safe

Abstract

Outpatient percutaneous coronary intervention (PCI) is safe in selected low risk population. Drug eluting stents (DESs) have expanded the indications of PCI to include more complex anatomies and multivessel disease. Outpatient PCI strategy (transfemoral access with manual sheath removal) is feasible and safe in the era wide utilization of DES. We enrolled 150 consecutive patients (males=82%, smokers=43%, diabetics=40%) referred for elective or semielective PCI. All patients were treated in the catheterization laboratory short-stay area. Procedural success was achieved in 97% of the cases. DESs were used in 88% of patients. Seventy-one percent of patients had single vessel PCI and 29% had multivessel PCI. The majority (n=124, 83%) was discharged within 10 h post-PCI (outpatient group) and 26 patients (17%) were admitted to the hospital for longer observation (hospital group). Of the outpatient group; there were no in-hospital deaths, myocardial infarctions or repeat revascularization. Two patients developed small femoral access site hematoma (treated conservatively). No readmissions or complications within 24 h after discharge were found. Administration of glycoprotein inhibitors and type-C lesion were independent predictors of failed same-day discharge. (i) Transfemoral outpatient PCI with manual sheath removal is feasible and safe in the era of DES. (ii) The majority of patients undergoing single or multivessel PCI can be discharged within 10 h postprocedure. (iii) Out-patient PCI has the potential of decreasing cost and improving hospital bed utilization.