A PILOT-STUDY OF CORONARY ANGIOPLASTY IN OUTPATIENTS

Background-Is it safe to discharge patients from hospital on the same day as percutaneous transluminal coronary angioplasty (PTCA)? The hypo thesis tested was that careful pre and angioplasty selection of patien ts identify a group that is at very low risk of postprocedural complic ations and that these patients may be discharged on the day of the pro cedure. Methods-63 patients undergoing limited risk coronary angioplas ty of 72 lesions were studied. So that patients would be able to walk soon after PTCA miniature equipment (6 French catheters and balloon-on -a-wire devices) was passed percutaneously through the right brachial artery. After coronary angioplasty patients with angiographic evidence of dissection and/or thrombus and with complications were assigned to an inpatient group and those in whom PTCA had achieved a good angiogr aphic result were assigned to an outpatient group. Results-Two patient s were excluded because the brachial approach failed, leaving 61 patie nts (70 lesions). After PTCA 50 patients (82%) with 57 lesions (81%) a ttempted were assigned to the outpatient group. No cardiac complicatio n occurred in this subset (0%; 95% confidence interval 0 to 7%). Eleve n patients (18%), in whom 13 lesions (19%) were attempted, were assign ed to the inpatient group. Three of these patients (27%; 95% confidenc e interval 6 to 61%) had cardiac complications. Two patients needed lo cal surgical repair after catheterisation of the brachial artery; one had a haematoma and one had a false aneurysm.Conclusions-Coronary angi oplasty with miniature equipment passed through the brachial artery wa s a safe procedure with a high initial success rate. The results of th is pilot trial suggest that with careful selection of patients before and after angioplasty PTCA can be performed safely in outpatients.