TY - JOUR
T1 - Same day discharge after chronic total occlusion interventions
T2 - A single center experience
AU - Koutouzis, Michael
AU - Liontou, Catherine
AU - Xenogiannis, Iosif
AU - Tajti, Peter
AU - Tsiafoutis, Ioannis
AU - Lazaris, Efstathios
AU - Oikonomidis, Nikolaos
AU - Kontopodis, Eleftherios
AU - Rangan, Bavana
AU - Brilakis, Emmanouil
N1 - Publisher Copyright:
© 2020 Wiley Periodicals LLC.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Objectives: To assess the feasibility and safety of same day discharge (SDD) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background: CTO PCI has been associated with higher complication rates and procedural and hospitalization costs. Shortening post-PCI hospitalization length not only increases the patients' comfort but at the same time it consists an important part of cost reduction policies. Methods: We retrospectively compared the 30-day outcomes of patients who underwent CTO PCI at the Red Cross Hospital, Greece between January 2016 and June 2019 and underwent SDD versus non-SDD. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction, urgent repeat target vessel revascularization, tamponade, and stroke. Results: A total of 173 patients (mean age 63.7 ± 8.9 years) were included, of whom 51 (30%) underwent SDD. SDD patients were less likely to have diabetes mellitus (51 vs. 31%, p =.015), arterial hypertension (89 vs. 67%, p <.001), and acute coronary syndrome presentation (39.7 vs. 21.6%, p =.022), compared with non-SDD patients. Forearm access was used in all SDD patients and in 83% of the non-SDD patients. The 30-day incidence of MACE was 0% in the SDD group and 1.6% in the non-SDD group. Multivariable analysis showed that diabetes mellitus and longer procedural time were associated with lower probability of SDD (OR: 0.34, 95% CI: 0.15, 0.73 and OR: 0.29, 95% CI: 0.12, 0.71, respectively). Conclusions: SDD appears to be feasible and safe in selected patients undergoing an uncomplicated CTO PCI through forearm approach.
AB - Objectives: To assess the feasibility and safety of same day discharge (SDD) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background: CTO PCI has been associated with higher complication rates and procedural and hospitalization costs. Shortening post-PCI hospitalization length not only increases the patients' comfort but at the same time it consists an important part of cost reduction policies. Methods: We retrospectively compared the 30-day outcomes of patients who underwent CTO PCI at the Red Cross Hospital, Greece between January 2016 and June 2019 and underwent SDD versus non-SDD. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction, urgent repeat target vessel revascularization, tamponade, and stroke. Results: A total of 173 patients (mean age 63.7 ± 8.9 years) were included, of whom 51 (30%) underwent SDD. SDD patients were less likely to have diabetes mellitus (51 vs. 31%, p =.015), arterial hypertension (89 vs. 67%, p <.001), and acute coronary syndrome presentation (39.7 vs. 21.6%, p =.022), compared with non-SDD patients. Forearm access was used in all SDD patients and in 83% of the non-SDD patients. The 30-day incidence of MACE was 0% in the SDD group and 1.6% in the non-SDD group. Multivariable analysis showed that diabetes mellitus and longer procedural time were associated with lower probability of SDD (OR: 0.34, 95% CI: 0.15, 0.73 and OR: 0.29, 95% CI: 0.12, 0.71, respectively). Conclusions: SDD appears to be feasible and safe in selected patients undergoing an uncomplicated CTO PCI through forearm approach.
KW - chronic total occlusion
KW - complex PCI
KW - health care policy
KW - percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85092537088&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092537088&partnerID=8YFLogxK
U2 - 10.1002/ccd.29320
DO - 10.1002/ccd.29320
M3 - Article
C2 - 33048434
AN - SCOPUS:85092537088
SN - 1522-1946
VL - 98
SP - 1232
EP - 1239
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 7
ER -