Segurança de procedimentos endovasculares arteriais dos membros inferiores em ambulatório – análise retrospetiva e codificação hospitalar

Abstract

AimRetrospective analysis of complications in a consecutive group of patients submitted to lower limb arterial endovascular procedures, comparing ambulatory and inpatient settings. MethodsDemographic and clinical details were collected from the clinical files of patients and a statistical software package (SPSS) was used for data analysis. ResultsFrom February 2010 to February 2012, 129 endovascular procedures were performed in 122 patients diagnosed with chronic lower limb ischemia. Twenty‐six patients were admitted to a day surgery unit. In total there were 13 procedural complications reported. Three hematomas were registered as puncture site complications with no intervention needed. Remote complications reported: AV fistulas in the crural arteries, spontaneously resolved; occlusion of the tibioperoneal trunk in one patient that subsequently was submitted to femoro‐posterior tibial bypass with vein conduit for worsening limb ischemia. One patient suffered transient worsening of his basal renal failure. There was no report of further systemic complications, need of ward admission or delay in hospital discharge for both group of patients. ConclusionGiven the relative low complication rates, its immediate identification and control as in this report, we admit that the majority of endovascular peripheral arterial procedures may be performed in ambulatory units. Further investigation should be pursued to disclose factors that may help select patients who better fit in an outpatient profile. The impact of costs in each health care setting should be taken into account in such shift towards ambulatory.