Clinical and Economic Evaluation of Ambulatory Endovascular Treatment of Peripheral Arterial Occlusive Lesions

Albert, Bénédicte; Davaine, Jean-Michel; Chaillet, Marie-Pierre; Grimandi, G.; Guyomarch, Béatrice; Azema, Laure; Costargent, Alain; Chaillou, Philippe; Patra, P.; Gouëffic, Yann

doi:10.1016/j.avsg.2013.06.008

Cited by 14 publications

(10 citation statements)

References 25 publications

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“…However, these studies were mostly performed with sheaths larger than 4F. In our study, the rate of ambulatory failure was 5% in both the groups, and thus was within the 0-27.3% range as reported in the literature [6][7][8]18].…”

Section: Ambulatory Failuresupporting

confidence: 83%

“…The use of VCDs may be associated with complications such as infection, bleeding, pseudoaneurysm, arterial laceration, arteriovenous fistulae, embolization, limb ischaemia, thrombosis, pain, dissection and nerve injury [8,15], and no data have shown the advantages of VCDs in terms of complications such as bleeding [16]. Therefore, the primary study hypothesis for providing the non-inferiority of the 4F group compared to the 6F group, considered a higher ASC-rate in the 6F group using VCDs.…”

Section: Access Site Complicationsmentioning

confidence: 99%

“…Although several reports have demonstrated ambulatory procedures to be safe and efficient, further evidence is needed to ensure the clinical and economic value of outpatients' management of PVIs [7]. Furthermore, most published data available refer to 6 French (F) devices [6,8]; however, 4F devices might be particularly useful in this setting as this low-profile approach can avoid the use of vascular closure devices (VCDs), and thus has the potential for reducing access-site-complications (ASCs) [9,10]. The 4-EVER trial confirmed the successful use of 4F devices without the need for closure devices with only 3.3% ASCs [11].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial

Brodmann

Deloose

Steinmetz

et al. 2020

Cardiovasc Intervent Radiol

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Purpose Ambulatory peripheral vascular interventions have been steadily increasing. In ambulatory procedures, 4F devices might be particularly useful having the potential to reduce access-site complications; however, further evidence on their safety and efficacy is needed. Materials and Methods BIO4AMB is a prospective, non-randomized mulitcentre, non-inferiority trial conducted in 35 centres in Europe and Australia comparing the use of 4F- and 6F-compatible devices. The main exclusion criteria included an American Society of Anaesthesiologists class ≥ 4, coagulation disorders, or social isolation. The primary endpoint was access-site complications within 30 days. Results The 4F group enrolled 390 patients and the 6F group 404 patients. Baseline characteristics were similar between the groups. Vascular closure devices were used in 7.7% (4F group) and 87.6% (6F group) of patients. Patients with vascular closure device use in the 4F group were subsequently excluded from the primary analysis, resulting in 361 patients in the 4F group. Time to haemostasis was longer for the 4F group, but the total procedure time was shorter (13.2 ± 18.8 vs. 6.4 ± 8.9 min, p < 0.0001, and 39.1 ± 25.2 vs. 46.4 ± 27.6 min, p < 0.0001). Discharge on the day of the procedure was possible in 95.0% (4F group) and 94.6% (6F group) of patients. Access-site complications were similar between the groups (2.8% and 3.2%) and included predominantly groin haematomas and pseudoaneurysms. Major adverse events through 30 days occurred in 1.7% and 2.0%, respectively. Conclusions Ambulatory peripheral vascular interventions are feasible and safe. The use of 4F devices resulted in similar outcomes compared to that of 6F devices.

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Section: Ambulatory Failuresupporting

confidence: 83%

Section: Access Site Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial

Brodmann

Deloose

Steinmetz

et al. 2020

Cardiovasc Intervent Radiol

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“…Outpatient procedure appears to be beneficial for both patients' quality of care and healthcare systems by relieving the pressure on hospital beds and material resources. [1][2][3] Long time lagging behind for the development of ambulatory surgeries and interventions, France has recently made significant progress in developing same-day discharge. Since 2010, same-day discharge has grown up to represent on average 56% of all surgeries and interventions but, depending on the medical procedure and geographical area, important variations can be observed.…”

Section: Introductionmentioning

confidence: 99%

Duration of sick leave after same-day discharge for lower extremity arterial disease and varicose vein interventions in active population of French patients, 2013–2016: observational study

et al. 2020

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ObjectiveTo assess whether disparities in rates of same-day discharge for lower extremities arterial disease (5%) and varicose vein interventions (90%) are associated with the burden of postprocedural rehabilitation process, measured through the duration of sick leave.DesignRetrospective observational study using French National Health Insurance data in 2012–2016.SettingThe French National Health Data System (Système National des Données de Santé), which covers 98.8% of the 66 million people in the French population.ParticipantsFrench workforce population aged 18 to 65 years old who underwent a first angioplasty with stent placement for lower extremities arterial disease (LEAD, n=30 238) or a first varicose vein intervention (n=265 670) between 2013 and 2016.Main outcome measuresDuration and renewals of sick leave within 180 days after endovascular intervention, continuity of care and prescription indices to assess coordination among healthcare professionals after intervention associated with specific intervention settings: conventional (inpatient) or same-day discharge (outpatient). Association was estimated by multivariate negative binomial regressions adjusting for age, gender and comorbidities.ResultsOutpatient settings decrease the incidence rate ratio (IRR) of the number of cumulated days of sick leave by 14% in both interventions. The increasing variety of prescribers decreases the IRR of cumulated days of sick leave and prescription renewals for varicose interventions by 25% and 21%, respectively, but increases them for LEAD interventions by 240% and 106%. Less coordination between healthcare specialists increases the IRR of cumulative days of sick leave and renewals by 37% and 29% for varicose, and 11% and 9% for LEAD interventions.ConclusionsLow rates of outpatients in LEAD angioplasty does not seem related to the duration of sick leave. Outpatient setting reduces the duration of sick leave and their renewals, whatever the intervention. Coordination of healthcare professionals is a key element of interventions follow-up with pathology specificities.

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“…The criteria on which patient to consider as suitable for day case cannot be easily standardized, however patients that are relatively fit, leave near by the hospital and have someone that stays with them overnight should be treated as day cases by the majority of the operators [15]. Patients that are frail, older than 80 years, have severe comorbidities, learning difficulties or leave alone still need to be performed as inpatients.…”

mentioning

confidence: 99%

Peripheral angioplasty as a day case: science fiction or everyday reality?

Krokidis

2016

Expert Review of Cardiovascular Therapy

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Clinical and Economic Evaluation of Ambulatory Endovascular Treatment of Peripheral Arterial Occlusive Lesions

Cited by 14 publications

References 25 publications

Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial

Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial

Duration of sick leave after same-day discharge for lower extremity arterial disease and varicose vein interventions in active population of French patients, 2013–2016: observational study

Peripheral angioplasty as a day case: science fiction or everyday reality?

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