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. 2021 Dec 1;98(7):1232-1239.
doi: 10.1002/ccd.29320. Epub 2020 Oct 13.

Same day discharge after chronic total occlusion interventions: A single center experience

Michael Koutouzis  1 , Catherine Liontou  1 , Iosif Xenogiannis  2 , Peter Tajti  2 , Ioannis Tsiafoutis  1 , Efstathios Lazaris  1 , Nikolaos Oikonomidis  1 , Eleftherios Kontopodis  1 , Bavana Rangan  2 , Emmanouil Brilakis  2
Affiliations

Same day discharge after chronic total occlusion interventions: A single center experience

Michael Koutouzis et al. Catheter Cardiovasc Interv. .

Abstract

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.

Keywords: chronic total occlusion; complex PCI; health care policy; percutaneous coronary intervention.

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References

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