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Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

  • Clinical Investigation
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Abstract

Purpose

The purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.

Materials and Methods

This was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.

Results

The study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.

Conclusions

Day-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

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Acknowledgments

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Authors and Affiliations

  1. Department of Interventional Radiology, Patras University Hospital, Patras, Greece

    Stavros Spiliopoulos, Dimitrios Karnabatidis & Panagiotis Kitrou

  2. Department of Interventional Radiology, Addenbrooke’s University Hospital, NHS Foundation Trust, Cambridge, UK

    Tariq Ali, Alessandro Cannavale & Miltiadis Krokidis

  3. Department of Interventional Radiology, Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, London, UK

    Konstantinos Katsanos & Athanasios Diamantopoulos

  4. 2nd Radiology Department, Division of Interventional Radiology, Attikon University General Hospital, 1st Rimini St, Chaidari, 12461, Athens, Greece

    Stavros Spiliopoulos

Authors
  1. Stavros Spiliopoulos
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  2. Dimitrios Karnabatidis
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  3. Konstantinos Katsanos
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Correspondence to Stavros Spiliopoulos.

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Conflict of Interest

The authors declare that they have no conflict of interest.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This study was a retrospective research involving human participants. For this type of study formal consent is not required.

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Spiliopoulos, S., Karnabatidis, D., Katsanos, K. et al. Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study. Cardiovasc Intervent Radiol 39, 1684–1691 (2016). https://doi.org/10.1007/s00270-016-1436-9

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  • DOI: https://doi.org/10.1007/s00270-016-1436-9

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