Same‐day transradial outpatient stenting with a 6‐hr course of glycoprotein IIb/IIIa receptor blockade: A feasibility study

Abstract

The aim of the study was to explore the feasibility of same-day outpatient stent placement using a short course of intravenous antiplatelet therapy. Patients (n = 26) had stent placement and 6 hr of eptifibatide therapy. Demographics, procedural information, CPK data, and length of stay were recorded along with postdischarge outcomes. Twenty-one men and five women with median age of 60 years (49, 69) underwent transradial stenting. Baseline characteristics included diabetes 62%, hyperlipidemia 77%, prior coronary bypass surgery 19%, and unstable angina 35%. There were no CPK elevations (> 2 x normal) or ECG changes. Discharge occurred after 6.5 hr (5.8, 7.0). Neither vascular site complications nor readmission for procedure-related problems occurred. One patient later expressed concerns about discharge education. Outpatient stent placement with 6-hr infusion of GP IIb/IIIa inhibitor appears feasible and efficient in select patients. There may be challenges to meet with regard to patient education. Further studies with larger populations are needed to evaluate and optimize this approach.

A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation

“…4 A few trials with no or abbreviated treatment with glycoprotein IIb-IIIa inhibitors have already demonstrated the feasibility and safety of same-day discharge after balloon angioplasty or stenting in selected low-risk patients. [5][6][7][8][9][10][11][12] Transradial PCI appears safer and potentially more costeffective than femoral PCI. 13 Several randomized trials have demonstrated fewer entry site complications after transradial PCI compared with femoral approach, including when femoral artery closure devices were used.…”

Transradial Approach for Coronary Interventions: The New Gold Standard for Vascular Access?

“…Numerous international studies are now available and even if not always randomized, they have validated this strategy after uncomplicated transradial percutaneous coronary interventions (106)(107)(108)(109)(110)(111)(112). No more access site complications are observed and the majority of events occurring 24 hours after discharge would not have been avoided by traditional next-day discharge.…”

Defining the length of stay following percutaneous coronary intervention

“…Peer-reviewed reports on outpatient PCI encompass a total of <5,000 patients and include centers reporting their outcomes in retrospective case series or prospective consecutive procedures with early discharge [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Table II). There are only three randomized studies comprising <2,000 patients in which early discharge was compared with an overnight stay [21,32,34].…”