Outpatient (Same-day care) Neuroangiography and Neurointervention

Abstract

PurposeThere have been few reports regarding same-day discharge following uncomplicated procedures such as cerebral angiography and neurointervention. We present same-day experience with cerebral angiography and neurointervention during the past three years.Materials and MethodsFour hundred and fifty-three patients underwent cerebral angiography or neurointervention at Asan Medical Center between January 2009 and December 2011. Of these patients, 249 (55%) underwent diagnostic catheter cerebral angiography and 204 patients (45%) underwent neurointerventional procedures as same-day procedures. We analyzed any complications, the modified patient-care process, the yearly trend in patient increases, disease categories, and the additional duration of admission for these procedures.ResultsThe number of overall patients increased by an average of 51% annually. The disease categories included aneurysm (51%), atherosclerosis (11%) and arteriovenous malformation (10%), etc. for which the patient underwent angiography, and aneurysm (42%), venous malformation (28%), and arteriovenous malformation (17%), etc. for which patients underwent neurointervention. Same-day care patients were admitted to the intermediary care unit in the angiosuite. Neurointervention patients were sent to the neurology intensive unit after the procedure. The same-day care patients stayed in angiosuite for six hours following the transfemoral procedure. The mean admission duration for neurointervention was 2.4 days. There were no reported complications for the same-day care procedures.ConclusionOur study revealed an increasing tendency toward same-day care for patients who require angiography and neurointervention. Further studies will be required to better define the cost-minimization effects of outpatient practice as well as the patient perception of this fast-tracking method. We propose that outpatient angiography and neurointervention will undoubtedly continue to increase over the next decade.

Next day discharge after elective intracranial aneurysm coiling: is it safe?

“…The median LOS in our study was 2.52 days, with 26.8% discharged on the day after the procedure (LOS <2 days); this is similar to the findings of other studies 8 17. The mean±SD LOS in our study was 3.99±6.1 days, which is slightly shorter than that reported by Hoh et al in the USA (4.5±7 days) 8.…”

“…The mean±SD LOS in our study was 3.99±6.1 days, which is slightly shorter than that reported by Hoh et al in the USA (4.5±7 days) 8. The mean LOS after intracranial interventional procedures in a more recent study was shorter (3.1 days) 17. However, that patient population was more heterogeneous and the type of intervention was not clearly defined.…”

Does a Low-wall Coverage Stent Have a Flow Diverting Effect in Small Aneurysms?

“…All UIAs were primarily identified by routine examinations using CTA or MRA. A final diagnosis was established on the basis of digital subtraction angiography (DSA), including 3D rotational angiography [ 7 ]. Five patients exhibited multiple aneurysms, either with two (n = 3), three (n = 1), or four (n = 1) aneurysms.…”

Outpatient Day-care Neuroangiography andNeurointerventionof Unruptured Intracranial Aneurysms

“…Our previous study showed that same-day care management of outpatients who underwent neuroangiography and neurointervention for various neurovascular diseases provided a shorter admission process and duration on an outpatient basis [ 16 ]. In this report, we present the process, outcome and duration of hospital stay for the management of UIAs via the Neurointervention Clinic over the past four years.…”