Samuel Ahn1, Monica J. Uceda1, Walter Kim2, Kenneth Kollmeyer1, Pablo Uceda1, Rhoda Leichter2, Craig Ferrara1, Todd Reil2, Robert Feldtman1, Joseph Caruso1, Karen McQuade1
1DFW Vascular Group, Dallas, TX; 2University Vascular Associates, Los Angeles, CA.
OBJECTIVES: The endovascular experience in an office-based angiosuite is different from that in a hospital suite. The office space has been viewed as unsafe because it lacks the safety net of immediate hospital resources. This study looks at the complication rates of 3,174 consecutive endovascular cases completed in our office-based angiosuites between April 2006 and December 2011.
METHODS: This experience represents 724 diagnostic angiograms, 773 angioplasties, 802 angioplasty with stents, 156 arteriovenous fistula declots, 430 radiofrequency ablations, 136 central venous accesses, and 15 coil embolizations. Indications for the procedures were peripheral vascular disease, chronic venous insufficiency, end stage renal disease, varicose veins, ulcers, stenosis of vessels outside the periphery, vertebrobasilar insufficiency, thrombophlebitis, malfunctioning access, and thoracic outlet syndrome.
RESULTS: Hypertension was present in 51% of the patients, while diabetes was present in 28% and coronary artery disease was present in 24%. 6% of patients were ASA class IV. The patient population was 57% female and 43% male (average age of 69±7.6, range 15-107). We had a total of 41 complications (1.29%), the most common being hematoma (15 cases) and device failure (14 cases). We encountered 1 patient that had to return to the angiosuite. 10 (0.32%) patients required immediate transfer, 11 (0.35%) required semi elective admission for observation and 4 (0.13%) required emergency surgery. Our low complication rate can be explained by the adoption and utilization of the sixth sigma culture of perfection and appropriate patient selection. The lowest complication rate reported in the literature from outpatient endovascular procedures is 2.1 %, which is significantly higher than our rate of 1.29% overall (p= 0.0135).
CONCLUSIONS: These data indicate that the outpatient office-based setting is a safe and effective environment for a patient undergoing an endovascular procedure.
AUTHOR DISCLOSURES: S. Ahn, Nothing to disclose; J. Caruso, Nothing to disclose; R. Feldtman, Nothing to disclose; C. Ferrara, Nothing to disclose; W. Kim, Nothing to disclose; K. Kollmeyer, Nothing to disclose; R. Leichter, Nothing to disclose; K. McQuade, Nothing to disclose; T. Reil, Nothing to disclose; M. J. Uceda, Nothing to disclose; P. Uceda, Nothing to disclose.
Posted April 2012