Management of Peripheral Vascular Interventions in an Ambulatory Setting: A Single-Center Retrospective Analysis.

ABSTRACT

BACKGROUND: The development of minimally invasive devices to treat peripheral artery disease led to a reduction of complications, particularly of the puncture or access site. Subsequently, the number of ambulatory procedures increased, saving costs and resources. This analysis was performed to provide data on patients treated with 4 French (F) compatible devices in ambulatory and in-hospital settings. METHODS: This is a single-center retrospective analysis of prospectively collected data. Consecutive patients who received peripheral vascular interventions from 2013 to 2015 were included. Data were extracted from electronic patients' files; data until the time of last contact were collected. Arterial puncture was performed under ultrasound guidance; 4F compatible devices ought to be selected and compression devices were used to seal the puncture site. The primary outcome was the rate of ambulatory failure in the ambulatory group. RESULTS: A total of 219 patients (68.5% male, 69.5 ± 12.8 years) were included in the analysis. Thereof 71 patients with 80 procedures were hospitalized, predominantly for social reasons (42/80, 52.5%) or emergency conditions (18/80, 22.5%). In the ambulatory group (148 patients), 183 procedures were performed, thereof 92.9% (170/183) with a 4F compatible equipment. Procedural success was 91.8% (168/183) in the ambulatory group and 82.5% (66/80) in the hospitalized group (P = 0.027). Patients in an ambulatory setting were younger and more frequently males. Ambulatory success was 99.2% (181/183). One puncture site complication was observed in each group but no other procedural complication, and all patients were alive after 1 month. In the ambulatory group, the mean follow-up was of 148 ± 260 days and in the hospitalized group, the mean follow-up was of 126 ± 199 days; no patient died during follow-up in the ambulatory group but 3 patients died in the hospitalized group. CONCLUSIONS: Ambulatory endovascular procedures can be safely performed in a large proportion of patients with peripheral artery disease.