Cardiac catheterisation by the Judkins technique as an outpatient procedure.

Oldroyd, Keith G.; Phadke, Kishor; Phillips, Rosalind; Carson, P; Clarke, Malcolm; Davis, Jamaine

doi:10.1136/bmj.298.6677.875

Cited by 33 publications

(12 citation statements)

References 7 publications

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“…We report a complication rate higher than that in the CECCC report2(1.9% with 95% confidence interval (CI) 1.3 to 2.5, v 0.8% with 95% CI 0.7 to 0.9), but similar to recent data from another UK centre9 (4.4% with 95% CI 3.1 to 5.8). The increased rate of vascular complications in the non-femoral group may be correlated with the high proportion of patients with severe peripheral vascular disease in that group (∼50%).…”

Section: Discussionsupporting

confidence: 87%

Diagnostic cardiac catheterisation in a hospital without on-site cardiac surgery

Papaconstantinou

Marshall

Burrell

1999

Heart

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Objective-To assess the feasibility, safety, and clinical impact of diagnostic cardiac catheterisation in a multipurpose laboratory in a district general hospital without cardiac surgery. (14% of the total) had another cardiac diagnosis for which they were investigated (for example, valvar heart disease). Referral for cardiac intervention following catheterisation was made in 1172 of the 2000 cases (intervention rate 59%; catheter:intervention ratio 1.7:1). The interventions performed were coronary artery bypass grafting (CABG) in 736 of the 1172 cases (63%), other types of cardiac surgery in 122 (10%), combined CABG and other cardiac surgery in 71 (6%), and percutaneous transluminal coronary angioplasty in 243 (21%). There were two catheter related deaths (0.1%), both of which occurred within 24 hours of the procedure, and a further nine major cardiovascular complications with residual morbidity (0.45%). These were myocardial infarction in two (0.1%), cerebrovascular events in two (0.1%), and surgical vascular complications in five (0.25%). In addition, there were eight successfully treated, life threatening arrhythmias (0.4%). Conclusions-Diagnostic cardiac catheterisation can be performed safely and successfully in a local hospital. When BCS guidelines are followed, the mortality is similar to published pooled data from regional centres (0.1% v 0.12%). The high intervention rate indicates a persistent unmet demand in the districts, which will continue to aVect surgical and interventional services. (Heart 1999;81:465-469)

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Section: Discussionsupporting

confidence: 87%

Diagnostic cardiac catheterisation in a hospital without on-site cardiac surgery

Papaconstantinou

Marshall

Burrell

1999

Heart

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“…Numerous studies have demonstrated that outpatient coronary angiography may be performed safely and with low complication rates [2,5,8,11,13,17,18,20,22,23,25,28]. The safety of outpatient cardiac catheterization and coronary angiography is, however, dependent upon a variety of factors.…”

Section: Safetymentioning

confidence: 98%

Outpatient coronary angiography: Indications, safety, and complication rates

Heuser

1998

Herz

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In the years since the introduction of outpatient cardiac catheterization and coronary angiography, the indications for the use of these procedures have expanded rapidly with advancements in surgical and endovascular procedures. The safety of outpatient coronary angiography has been well established, comparing very favorably with that of inpatient procedures. At present, a variety of different outpatient facilities exist. Catheterization laboratories may adjoin a hospital or be free-standing; the safety and success of procedures performed in mobile cardiac catheterization laboratories has also been described. There are a variety of access techniques for cardiac catheterization in use today, and there are many types and sizes of catheters available. Miniaturization of equipment has reduced complications and allowed early ambulation and discharge from outpatient laboratories. In addition, the development and refinement of catheters and techniques for achieving hemostasis may allow further reductions in patient stay and complications. The complication rates of outpatient cardiac catheterization and coronary angiography are, in fact, quite low--in some cases, lower complication rates are seen in the outpatient population than in the inpatient population. Although this is certainly related in part to the fact that outpatients generally have more stable disease, it is clear that careful equipment choices, proper technique, and adequate monitoring have contributed to the success of these important outpatient procedures.

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“…The pressure to investigate more patients with ischaemic heart disease by coronary angiography has led to a move to study many of these patients as day cases [1,2]. The use of small diameter (5F), coronary catheters has been promoted [3] with the suggestion that they may have advantages related to smaller puncture sites and that they are more suitable for outpatient angiography.…”

Section: Introductionmentioning

confidence: 99%

Limitations in the use of five french coronary catheters

et al. 1991

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Five french (5F) catheters are being widely promoted for use in patients undergoing day case angiography including coronary angiography. Although there are theoretical advantages to this practice there are also potential disadvantages. We reviewed various performance parameters of four different brands of 5F coronary catheter and compared them with performance of the six (6F) and eight french (8F) coronary catheters used in routine coronary angiography. All the 5F catheters performed significantly less satisfactorily than the 6F and 8F catheters. 5F coronary catheters cannot be recommended for routine transfemoral coronary angiography.

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Cardiac catheterisation by the Judkins technique as an outpatient procedure.

Cited by 33 publications

References 7 publications

Diagnostic cardiac catheterisation in a hospital without on-site cardiac surgery

Diagnostic cardiac catheterisation in a hospital without on-site cardiac surgery

Outpatient coronary angiography: Indications, safety, and complication rates

Limitations in the use of five french coronary catheters

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