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

• Published in: The American heart journal 2003-10, Vol.146 (4), p.699-704
• Main Authors: Ziakas, A.A, Klinke, B.P, Mildenberger, C.R, Fretz, D.E, Williams, E.M.B, Kinloch, F.R.D, Hilton, G.J.D
• Format: Article
• Language: English
• Subjects: Ambulatory Care; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - methods; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Coronary Disease - therapy; Coronary vessels; Female; Heart attacks; Humans; Length of Stay; Male; Medical sciences; Middle Aged; Myocardial Infarction - therapy; Patient satisfaction; Retrospective Studies; Safety; Stents
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(03)00258-8

The safety and feasibility of same-day discharge percutaneous coronary intervention (PCI) is still controversial. Patients (n = 943) had same-day discharge radial PCI between April 1998 and March 2001 in our hospital. Patients were contacted and asked whether they had entry site complications or a repeat angiogram and/or PCI within 24 hours and 1 month after the procedure. At the time the study was conducted, 811 patients responded, 38 patients had died, and 94 were alive but refused to participate or it was impossible to contact them; 27 patients (2.8%) visited their doctor and/or the hospital within 24 hours after discharge because of entry site complications, and 38 patients (4.0%) visited within 1 month. However, none of the patients had major access site complications or needed to be admitted to the hospital. Within 24 hours from discharge 17 patients (2%) reported chest pain, and only 1 (0.1%) required a repeat angiogram, which did not show target vessel occlusion. During the first month, 94 patients (11.5%) reported chest pain, 11 (1.3%) underwent a repeat angiogram, out of which 4 had subacute vessel closure; 2 of the 132 patients that we could not contact had subacute stent thrombosis within 1 month and died. None of the patients having same-day discharge radial PCI had major access site complications. Six patients (0.6%) had subacute vessel closure, but none had this during the first 24 hours after discharge. Same-day discharge radial PCI in certain low-risk patients is a safe and feasible strategy.