Safety of same-day–discharge radial percutaneous coronary intervention: a retrospective study

Ziakas, Antonios; Klinke, B.P; Mildenberger, C.R; Fretz, D.E; Williams, Edgar M.; Kinloch, F.R.D; Hilton, Graham

doi:10.1016/s0002-8703(03)00258-8

Cited by 64 publications

(53 citation statements)

References 25 publications

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“…4 A few trials with no or abbreviated treatment with glycoprotein IIb-IIIa inhibitors have already demonstrated the feasibility and safety of same-day discharge after balloon angioplasty or stenting in selected low-risk patients. [5][6][7][8][9][10][11][12] Transradial PCI appears safer and potentially more costeffective than femoral PCI. 13 Several randomized trials have demonstrated fewer entry site complications after transradial PCI compared with femoral approach, including when femoral artery closure devices were used.…”

Section: Editorial P 2578 Clinical Perspective P 2643mentioning

confidence: 99%

A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation

et al. 2006

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for the Early Discharge After Transradial Stenting of Coronary Arteries (EASY) Study InvestigatorsBackground-Systematic use of coronary stents and optimized platelet aggregation inhibition has greatly improved the short-term results of percutaneous coronary interventions. Transradial percutaneous coronary interventions have been associated with a low risk of bleeding complications. It is unknown whether moderate-and high-risk patients can be discharged safely the same day after uncomplicated transradial percutaneous coronary interventions. Methods and Results-We randomized 1005 patients after a bolus of abciximab and uncomplicated transradial percutaneous coronary stent implantation either to same-day home discharge and no infusion of abciximab (group 1, nϭ504) or to overnight hospitalization and a standard 12-hour infusion of abciximab (group 2, nϭ501). The primary composite end point of the study was the 30-day incidence of any of the following events: death, myocardial infarction, urgent revascularization, major bleeding, repeat hospitalization, access site complications, and severe thrombocytopenia. The noninferiority of same-day home discharge and bolus of abciximab only compared with overnight hospitalization and abciximab bolus and infusion was evaluated. Two thirds of patients presented with unstable angina and Ϸ20% presented with high-risk acute coronary syndrome prior to the procedure. The incidence of the primary end point was 20.4% in group 1 and 18.2% in group 2 (Pϭ0.017 for noninferiority) with a troponin T-based definition of myocardial infarction; the incidence of the primary end point was 11.1% in group 1 and 9.6% in group 2 (Pϭ0.0004 for noninferiority) with a creatinine kinase myocardial band-based definition of myocardial infarction. No death occurred. Rate of major bleeding in both groups was extremely low at 0.8% and 0.2%, respectively. From 504 patients randomized in group 1, 88% were discharged home the same day. Conclusion-Our data suggest that same-day home discharge after uncomplicated transradial coronary stenting and bolus only of abciximab is not clinically inferior, in a wide spectrum of patients, to the standard overnight hospitalization and a bolus followed by a 12-hour infusion. This novel approach offers a safe strategy for same-day home discharge after uncomplicated coronary intervention. (Circulation. 2006;114:2636-2643.)

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Section: Editorial P 2578 Clinical Perspective P 2643mentioning

confidence: 99%

A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation

et al. 2006

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“…7,14 Ha existido un notable progreso en la calidad y miniaturización de los catéteres guías, lo que ha posibilitado reducir los introductores desde 9 Fr a 6 o 5 FR. Esto posibilita que Evaluación a largo plazo del impacto funcional y estructural de la arteria radial post acceso en intervencionismo coronario Pedreros P, et al…”

Section: Discussionunclassified

Evaluación a largo plazo del impacto funcional y estructural de la arteria radial post acceso en intervencionismo coronario

et al. 2010

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Antecedentes: El acceso radial es una alternativa aceptable y segura para procedimientos endovasculares. Sin embargo no existe una clara evaluación de la integridad de la arteria radial (AR) post procedimiento. Objetivo: Evaluar el impacto funcional y estructural a largo plazo de la punción y colocación del introductor vascular en arteria radial (AR) post intervencionismo coronario. Método: Se estudian 33 pacientes con cardiopatía coronaria a quienes se realizó coronariografía y/o angioplastía vía radial. A los 6-10 meses de seguimiento se analizó las características ecográficas funcionales y estructurales de la AR comparándola con la AR contralateral.Resultados: Con el seguimiento se observan 3 AR ocluidas (9%). No se encontró un aumento significativo del grosor de la pared a nivel distal (zona de punción), 0,36 ± 0,22 vs 0,28 ± 0,08mm; el diámetro fue similar a nivel distal 2,6 ± 0,7mm vs 2,8 ± 0,35mm (ns) y proximal 2,8 ± 0,35 vs 2,5 ± 0,7mm. No hay diferencia significativa en la velocidad peak sistólica (VPS), en la AR puncionada vs la control 54 ± 16 vs 50 ± 14 cm/seg ni en los índices de resistencia 0,83 ± 0,1 vs 0,87 ± 0,1. Conclusiones: La utilización de la vía radial para intervencionismo coronario ocasiona en un bajo porcentaje la oclusión esta arteria. En las arterias que permanecen permeables no se encontró a largo plazo un impacto sobre las características estructurales ni funcionales.Background: the radial artery is a common and safe access site for endovascular procedures. There has been no adequate evaluation of the radial artery integrity following the procedure. Aim: to evaluate the long term functional and structural status of the radial artery use for cardiac interventional procedures Methods: 33 patients with coronary artery disease had coronary angiography and/or PTCA using the radial artery approach. After 6 -10 months the functional and structural status of the artery was evaluated by comparison to the contra lateral artery. Results: Three (9%) arteries were occluded. No thic-

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“…Peer-reviewed reports on outpatient PCI encompass a total of <5,000 patients and include centers reporting their outcomes in retrospective case series or prospective consecutive procedures with early discharge [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Table II). There are only three randomized studies comprising <2,000 patients in which early discharge was compared with an overnight stay [21,32,34].…”

Section: Data Supporting the Use And Safety Of Outpatient Pcimentioning

confidence: 99%

Defining the length of stay following percutaneous coronary intervention

Chambers

Dehmer

Cox

et al. 2009

Cathet Cardio Intervent

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Percutaneous coronary intervention (PCI) is the most common method of coronary revascularization. Over time, as operator skills and technical advances have improved procedural outcomes, the length of stay (LOS) has decreased. However, standardization in the definition of LOS following PCI has been challenging due to significant physician, procedural, and patient variables. Given the increased focus on both patient safety as well as the cost of medical care, system process issues are a concern and provide a driving force for standardization while simultaneously maintaining the quality of patient care. This document:(1) provides a summary of the existing published data on same-day patient discharge following PCI, (2) reviews studies that developed methods to predict risk following PCI, and (3) provides clarification of the terms used to define care settings following PCI. In addition, a decision matrix is proposed for the care of patients following PCI. It is intended to provide both the interventional cardiologist as well as the facilities, in which they are associated, a guide to allow for the appropriate LOS for the appropriate patient who could be considered for early discharge or outpatient intervention. V C 2009 Wiley-Liss, Inc.

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Safety of same-day–discharge radial percutaneous coronary intervention: a retrospective study

Cited by 64 publications

References 25 publications

A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation

A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation

Evaluación a largo plazo del impacto funcional y estructural de la arteria radial post acceso en intervencionismo coronario

Defining the length of stay following percutaneous coronary intervention

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