Outpatient Cardiac Catheterization and Angiography: Safety and Experience with Transradial Approach

Abstract

Background and Objectives:The safety and efficacy of outpatient cardiac catheterization was established.4 We evaluated our patient population and complications selected for outpatient procedures and our experience with transradial approach. Materials and Methods:A total of 346 outpatient cardiac catheterization (31% of all diagnostic procedures), performed with transradial approach, was compared with 788 inpatient diagnostic pr-ocedures in terms of patient population, clinical and angiographic features, complications of examinations. Results:1) Indications of outpatient coronary angiography were as follows;follow-up of coronary interventions or bypass surgery (41.6%), recent-onset or aggravated angina (31.2%), atypical chest pain (19.4%), stable angina (3.8%), recent myocardial infarction (2.9%), variant angina (0.9%), preoperative evaluation of valvular or congenital heart disease (0.3%). 2) Significant coronary lesions were found in 216 (62.5%) patients and left main disease in 12 (3.5%). Coronary spasm test, internal mammary artery or saphenous vein graft angiography, aorto-ileofemoral angiography, and bilateral carotid angiography were safely performed as indicated. 3) Success rate of examination by primary approach was 94.5%, similar to 94.9% of inpatients. Alternative brachial or femoral approaches were needed in 19 (5.5%) patients. 4) No death, cerebral thromboembolism or myocardial infarction were observed and one-day admission was required in 13 (3.7%) patients. Initial 254 patients (33%) showed good radial pulse (94%), weak or absent radial pulse (6%), abnormal reverse Allen test (6%) up to 61±25 days. However, no claudication was observed. Conclusion:Cardiac catheterization and angiography was safely performed in the outpatient population selected using much extended inclusion criteria. Transradial approach is useful to set up outpatient procedures with 논문접수일:1999년 3월 18일 심사완료일:1999년 9 월 1일 교신저자:차광수, 602-715 부산광역시 서구 동대신동 3가 1 동아대학교 의과대학 내과학교실 전화:(051) 240-5620·전송:(051) 242-1449 E-mail:happy@damc.dauosp.or.kr