OUTPATIENT ENDOVASCULAR INTERVENTION - IS IT SAFE

Purpose: To evaluate the feasibility and safety of outpatient percutan eous endovascular intervention in the treatment of arterial occlusive disease. Methods: The records of 134 patients who underwent 151 outpat ient endovascular procedures between 1992 and 1997 were reviewed retro spectively. According to established protocol, focal lower limb (n = 1 45) and subclavian (n = 6) arterial lesions requiring relatively strai ghtforward endoluminal interventions were appropriate for outpatient m anagement provided the patients were free of significant comorbidities . A percutaneous transfemoral approach was used for lower limb lesions , while subclavian angioplasty was performed via a brachial access. He parin anticoagulation was administered conservatively. Patients were d ischarged 3 hours after sheath removal. Results: The majority (98%) of patients were discharged as planned. Three (2%) patients were observe d overnight in the hospital for treatment of acute iliac artery thromb osis, puncture-site bleeding, and suboptimal angioplasty. No patient r equired hospitalization following discharge. Periprocedural morbidity was confined to 2 (1.5%) groin hematomas and 1 (0.7%) femoral pseudoan eurysm. Conclusions: Outpatient endovascular intervention appears safe ; however, proper case selection and technical excellence are insepara ble components for the success of this strategy.