Ambulatory Percutaneous Angioplasty in Patients With Claudication

Maurel, Blandine; Paumier, A.; Jacobi, David; Bleuet, François; Martinez, Robert; Lermusiaux, Patrick

doi:10.1016/j.avsg.2010.08.007

Cited by 17 publications

(11 citation statements)

References 13 publications

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“…According to this classification, 14 major and 13 minor complications were reported with an overall rate of complications of 4.1%, similar to those of other studies [16,17,19]. The conversion rate reported by different studies shows a large range from 0 to 20% [6,14,22]. In the present study, outpatient protocol could be accomplished in 98.2% of procedures.…”

Section: Discussionsupporting

confidence: 88%

“…While numerous large studies regarding outpatient percutaneous coronary intervention demonstrated the safety and feasibility of this method [11][12][13], the large studies in the field of interventional radiology are less pronounced. Although different studies have attempted to demonstrate the feasibility and safety of outpatient percutaneous revascularization in patients with PAD [7,9,[14][15][16][17], the majority of studies have been focused on highly selected patients such as excluding the patients with critical limb ischemia or previous lower limb vascular surgery. However, what was revealed was that in almost every situation, complications occur during the procedure or during the 6 hours observation period, and therefore the outpatient approach will not alter the outcomes [8,9,16,18].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety of elective percutaneous peripheral revascularization in outpatients: A 10-year single-center experience

Malekzadeh

Rolf

Doenz

et al. 2019

Diagnostic and Interventional Imaging

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Safety of elective percutaneous peripheral revascularization in outpatients: A 10-year single-center experience

Malekzadeh

Rolf

Doenz

et al. 2019

Diagnostic and Interventional Imaging

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“…First, as our work considered only inpatient costs, and does not directly capture outpatient care that may be provided in wound care centers, outpatient angiography suites, and ambulatory imaging centers 36-38 . Even though the significant burden of comorbidities carried by patients with critical limb ischemia most commonly necessitates hospital-based care, vascular care is increasingly provided in outpatient settings 39, 40 .…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Regional Spending on Vascular Care and Amputation Rate

et al. 2014

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Importance While lower extremity revascularization is effective in preventing amputation, the relationship between spending on vascular care and regional amputation rates remains unclear. Objective To test the hypothesis that higher regional spending on vascular care is associated with lower amputation rates in patients with severe peripheral arterial disease (PAD). Design Retrospective cohort study. Setting United States Medicare patients, 2003-2010 Participants 18,463 patients who underwent major PAD-related amputation. Exposures Price-adjusted Medicare spending on revascularization procedures and related vascular care in the year before lower extremity amputation, across hospital referral regions. Main Outcome Measure(s) Correlation coefficient between regional spending on vascular care and regional rates of PAD-related amputation. Results Among patients ultimately subject to amputation, 64% were admitted to the hospital in the year prior to amputation for revascularization, wound-related care, or both; 36% were admitted only for their amputation. The mean cost of inpatient care in the year before amputation, including the amputation itself, was $22,405, but varied from $11,077 (Bismarck, North Dakota) to $42,613 (Salinas, California) (p<0.001). Patients in high-spending regions were more likely to undergo vascular procedures in crude analyses (12.0 procedures per 10,000 patients in the lowest quintile of spending, 20.4 procedures per 10,000 patients in the highest quintile of spending, p<0.0001), as well as in risk-adjusted analyses (adjusted OR for receiving a vascular procedure in highest quintile of spending = 3.5, 95 % CI 3.2-3.8, p<0.0001). While revascularization was associated with higher spending (R=0.38, p<0.001), higher spending was not associated with lower regional amputation rates (R=0.10, p=0.06). Regions most aggressive in the use of endovascular interventions which most likely to have high spending (R=0.42, p=0.002) and high amputation rates (R=0.40, p=0.004). Conclusions Regions that spend the most on vascular care is highest perform the most procedures, especially endovascular interventions, in the year before amputation. However, there is little evidence that higher regional spending is associated with lower amputation rates. This suggests an opportunity to limit costs in vascular care without compromising quality.

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“…Previous clinical studies have shown that most complications such as entry site bleeding, damage to blood vessels, or internal bleeding arise either during or within 4 hr of the endovascular procedure. Therefore we believed it is reasonable to discharge the patient after 4–6 hr of observation, provided they (1) have safely ambulated ; (2) understand the instructions; (3) are able to recognize a complication; and (4) have adequate social support in place .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore we believed it is reasonable to discharge the patient after 4-6 hr of observation, provided they (1) have safely ambulated [7][8][9]; (2) understand the instructions; (3) are able to recognize a complication;…”

mentioning

confidence: 99%