Mobile cardiac catheterization registry: Report of the first 1,001 patients

Bersin, Robert M.; Elliott, Charles M.; Elliott, Allison V.; Fedor, John M.; Gallagher, John J.; Jordan, Lisa; Simonton, Charles A.; Svenson, Robert H.; Wilson, B. Hadley; Zimmern, Samuel H.

doi:10.1002/ccd.1810310102

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…This hypothesis is supported by our results in that both the mortality and the complication rate are below those reported previously. Our data are in line with 0% mortality in outpatient cardiac catheterization reported from other investigators [7–9]. However, these studies included a smaller number of procedures in a highly selected low‐risk population for procedural complications and may therefore underestimate mortality rate in real‐world practice.…”

Section: Discussionsupporting

confidence: 89%

Procedural complications following diagnostic coronary angiography are related to the operator's experience and the catheter size

Ammann

Rocca

Angehrn

et al. 2003

Cathet Cardio Intervent

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Cardiac catheterization is performed routinely in hospitals all around the world. Extensive analysis of complications has been performed in the 1980s and early 1990s. However, because of the new therapeutic innovations based on advanced catheter technologies, these data may not apply to the present situation. Still, there are few data about procedural complications of diagnostic cardiac catheterization over the last 10 years. A total of 7,412 consecutive diagnostic cardiac catheterizations were performed between January 1990 and December 2000 and prospectively assessed in a registry. There were a total of 63 complications, of which 40 were minor and 23 major. Thus, the overall complication rate was 0.8%, with a mortality rate of 0%. Univariate analysis showed lower overall complication rate of senior physicians (> 500 coronary angiographies performed; OR ‫؍‬ 0.58; 95% CI ‫؍‬ 0.34 -0.98; P ‫؍‬ 0.04), smaller catheter size (< 6, 6, > 6 Fr: OR ‫؍‬ 2.6; 95% CI ‫؍‬ 1.53-4.41; P ‫؍‬ 0.0004), and a higher rate in patients having left and right heart catheterization (OR ‫؍‬ 2.62; 95% CI ‫؍‬ 1.46 -4.7; P ‫؍‬ 0.003). Major complications were associated with larger catheters (< 6, 6, > 6 Fr: OR ‫؍‬ 2.35; 95% CI ‫؍‬ 1.0 -5.51; P ‫؍‬ 0.05), whereas vascular complications occurred more often with higher body weight (per 10 kg: OR ‫؍‬ 1.4; 95% CI ‫؍‬ 1.01-1.95; P ‫؍‬ 0.04). Overall complication rate in diagnostic coronary angiography is very low and related to the experience of the performing cardiologist and catheter size. The only predicting risk factors for major complications in coronary angiography were catheter size and body weight. Cathet Cardiovasc Intervent 2003;59: 13-18.

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Section: Discussionsupporting

confidence: 89%

Procedural complications following diagnostic coronary angiography are related to the operator's experience and the catheter size

Ammann

Rocca

Angehrn

et al. 2003

Cathet Cardio Intervent

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“…Although initially a procedure performed only in the hospital, the demand Ÿ the procedure has led to the development of a number of outpatient facilities [29]. In some cases, these facilities adjoin a hospital or clinic, while in others, the facility is freestanding or even a mobile unit [4]. The major goals of these types of laboratories ate to reduce costs and bring coronary angiography closer to those who need it [29].…”

Section: Schlªmentioning

confidence: 99%

Outpatient coronary angiography: Indications, safety, and complication rates

Heuser

1998

Herz

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In the years since the introduction of outpatient cardiac catheterization and coronary angiography, the indications for the use of these procedures have expanded rapidly with advancements in surgical and endovascular procedures. The safety of outpatient coronary angiography has been well established, comparing very favorably with that of inpatient procedures. At present, a variety of different outpatient facilities exist. Catheterization laboratories may adjoin a hospital or be free-standing; the safety and success of procedures performed in mobile cardiac catheterization laboratories has also been described. There are a variety of access techniques for cardiac catheterization in use today, and there are many types and sizes of catheters available. Miniaturization of equipment has reduced complications and allowed early ambulation and discharge from outpatient laboratories. In addition, the development and refinement of catheters and techniques for achieving hemostasis may allow further reductions in patient stay and complications. The complication rates of outpatient cardiac catheterization and coronary angiography are, in fact, quite low--in some cases, lower complication rates are seen in the outpatient population than in the inpatient population. Although this is certainly related in part to the fact that outpatients generally have more stable disease, it is clear that careful equipment choices, proper technique, and adequate monitoring have contributed to the success of these important outpatient procedures.

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“…It was recognized that the high-quality radiographic equipment available for such laboratories could make the quality of these studies equal to any hospital-based facility. The publication in this journal issue by Bersin et al [2] has provided the first prospective study of efficacy and safety. Of the 1,001 patients studied, only two examinations were aborted because of patient disease, giving a 99.9% technical success rate.…”

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confidence: 97%

“…Bersin et al [2] emphasize that only 27% of patients required any further intervention. This implies that 73% of the patients could have made a single trip for evaluation, possible stress testing, and, if necessary, outpatient angiographic study at a tertiary facility, all of which can easily be accomplished in a day or two.…”

mentioning

confidence: 98%