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Seneviratne N, Huang DY, Wilkins CJ, Peddu P, Sidhu PS. 25 Years of day-case interventional radiology at King's College Hospital, London: worth the effort. Clin Radiol 2023; 78:633-634. [PMID: 37311681 DOI: 10.1016/j.crad.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/15/2023]
Affiliation(s)
- N Seneviratne
- King's College Hospital NHS Foundation Trust, London, UK.
| | - D Y Huang
- King's College Hospital NHS Foundation Trust, London, UK
| | - C J Wilkins
- King's College Hospital NHS Foundation Trust, London, UK
| | - P Peddu
- King's College Hospital NHS Foundation Trust, London, UK
| | - P S Sidhu
- King's College Hospital NHS Foundation Trust, London, UK; King's College London, London, UK
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2
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Krishnaswamy A, Isogai T, Brilakis ES, Nanjundappa A, Ziada KM, Parikh SA, Rodés-Cabau J, Windecker S, Kapadia SR. Same-Day Discharge After Elective Percutaneous Transcatheter Cardiovascular Interventions. JACC Cardiovasc Interv 2023; 16:1561-1578. [PMID: 37438024 DOI: 10.1016/j.jcin.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/23/2023] [Accepted: 05/08/2023] [Indexed: 07/14/2023]
Abstract
Percutaneous transcatheter interventions have evolved as standard therapies for a variety of cardiovascular diseases, from revascularization for atherosclerotic vascular lesions to the treatment of structural cardiac diseases. Concomitant technological innovations, procedural advancements, and operator experience have contributed to effective therapies with low complication rates, making early hospital discharge safe and common. Same-day discharge presents numerous potential benefits for patients, providers, and health care systems. There are several key elements that are shared across the spectrum of interventional cardiology procedures to create a successful same-day discharge pathway. These include appropriate patient and procedure selection, close postprocedural observation, predischarge assessments specific for each type of procedure, and the existence of a patient support system beyond hospital discharge. This review provides the rationale, available data, and a framework for same-day discharge across the spectrum of coronary, peripheral, and structural cardiovascular interventions.
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Affiliation(s)
- Amar Krishnaswamy
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Toshiaki Isogai
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Aravinda Nanjundappa
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Khaled M Ziada
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sahil A Parikh
- Division of Cardiology and Center for Interventional Vascular Therapy, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Josep Rodés-Cabau
- Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Samir R Kapadia
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
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3
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Roson N, Antolin A, Mast R, Sanchéz-Tirado C, Griñón J, Andreu J, Perez Lafuente M, Tomasello A, Escobar M. Experience and results after the implementation of a radiology day unit in a reference hospital. Insights Imaging 2022; 13:109. [PMID: 35767122 PMCID: PMC9243205 DOI: 10.1186/s13244-022-01251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Interventional radiological procedures have significantly increased in recent years. Most of them are minimally invasive and require a short hospitalization, mainly done in other non-radiological units nowadays. Limited bed availability and high occupancy rates in these units create longer waiting lists and cancellations. The aim of this retrospective study is to assess the creation and functioning of a Radiology Day Unit (RDU) and evaluating its outcomes. For this purpose, data about interventional procedures and its complications, incidents, patient safety, quality and satisfaction rates were collected from May 2018 to December 2020, and posteriorly analyzed to evaluate its implementation. Results During the assessed period, 3841 patients were admitted into the RDU, with a net increase of 13% and 26% in the second and third year, respectively. Procedures performed by the Abdominal Radiology section were the most frequent (76–85%) followed by Interventional Vascular Radiology and Thoracic Radiology. Complication rates were low (1.5%) and most of them were self-limited and managed in the own department. Waiting lists were significantly reduced, from 2 months to 1 week in case of procedures performed by the Abdominal Radiology section. Patient satisfaction was higher than 80% in all the items evaluated with a global satisfaction of 93%. Conclusion The RDU in our hospital has become a vital section for the management and post-procedure caring of patients undergoing interventional procedures in the Radiology Service with low complication rates and overall high levels of quality and patient safety, allowing the reduction of waiting lists and occupancy rates.
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Affiliation(s)
- Nuria Roson
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Andreu Antolin
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - Richard Mast
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Cristina Sanchéz-Tirado
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Jesús Griñón
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Jordi Andreu
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Mercedes Perez Lafuente
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Alejandro Tomasello
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Manuel Escobar
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
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4
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Wells R. Ambulatory care in interventional radiology: a framework for radiology day-case. Clin Radiol 2022; 77:489-495. [DOI: 10.1016/j.crad.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/15/2022] [Indexed: 11/03/2022]
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5
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Hamady M, McCafferty I. The rocky road to recognizing interventional radiology as a full clinical speciality. CVIR Endovasc 2021; 4:7. [PMID: 33409817 PMCID: PMC7787593 DOI: 10.1186/s42155-020-00202-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Mohamad Hamady
- Department of Interventional Radiology, Imperial College-London, Praed Street, London, W2 1NY, UK.
| | - Ian McCafferty
- Consultant Interventional Radiologist, Queen Elizabeth Hospital, Birmingham, UK
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Rostampour S, Cleveland T, White H, Haslam P, McCafferty I, Hamady M. Response of UK interventional radiologists to the COVID-19 pandemic - survey findings. CVIR Endovasc 2020; 3:41. [PMID: 32592080 PMCID: PMC7317887 DOI: 10.1186/s42155-020-00133-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/18/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an unprecedented effect upon the National Health Service (NHS). Like other specialties, Interventional Radiology (IR) rapidly adapted to the evolving situation. Members of BSIR were surveyed to obtain a snapshot of the experiences of UK IRs in response to COVID-19. An electronic survey was compiled using Google Forms, approved by the BSIR Council Officers and distributed to BSIR members by email on 18 th April 2020. A total of 228 responses were received. The survey was open for a 14-day period and the data analysed in Microsoft Excel 365. The response rate was 29% (228/800). RESULTS Two thirds of respondents work in a Tertiary unit and 33% deliver IR in a District Hospital. 84% have a day-case facility. After the COVID-19 crisis, 81% of respondents were able to maintain 24-7 On-call service. 59% of respondents had been required change their day to day practice to allow the on-call service to continue. 55% of respondents were involved in providing a central line service. Of those questioned, 91% continued to offer endovascular services, 98% genitourinary and 92% hepatobiliary services, although a degree of service reduction was described. 38% have provided IR trainees with additional training material during this pandemic. CONCLUSIONS This survey has confirmed that the responses of UK IR departments to the COVID-19 crisis have ensured vital on-call and urgent services have continued, including ongoing availability of most IR sub-specialties. Availability of a day case facility has possibly influenced the positive response.
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Affiliation(s)
| | - Trevor Cleveland
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Philip Haslam
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian McCafferty
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Mo Hamady
- Imperial College Healthcare NHS Trust, London, UK
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7
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Peripheral Vascular Disease and Implication of Nursing Practice: A Brief Literature Review. Adv Ther 2020; 37:686-691. [PMID: 31953806 DOI: 10.1007/s12325-020-01222-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Indexed: 10/25/2022]
Abstract
Nowadays nurse practitioners are working in several acute hospital settings in different specialized departments. For decades, studies have shown the implications of nurse practice in peripheral vascular disease (PVD) and peripheral vascular intervention (PVI) to have several major benefits. However, there are very limited studies and data on this particular aspect. In this literature review, we briefly discuss the implication of nursing practice in PVD/PVI. This review briefly shows that nursing practice has a major contribution and implication in the treatment of patients with PVD or PVI, especially in patients with diabetes mellitus. From available research, we briefly discuss the implication of nursing practice pre- and postoperatively for PVI. Nurses also contribute significantly in catheter-directed thrombolytic therapy, in smoking cessation programs organized for patients with PVD, and in screening patients for PVD. The vascular nurse practitioners are also involved in providing healthcare advice in order to reduce the risk of disease progression. The major lack of research in this particular field should further inspire scientists to develop and carry out research to further investigate and demonstrate the contribution of nurses in the treatment and management of PVD or PVI, which is gradually becoming a major issue.
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Kok HK, Rodt T, Fanelli F, Hamady M, Müller-Hülsbeck S, Santiago MC, Wolf F, Lee MJ. Clinical and endovascular practice in interventional radiology: a contemporary European analysis. CVIR Endovasc 2019; 1:8. [PMID: 30652141 PMCID: PMC6319508 DOI: 10.1186/s42155-018-0010-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/22/2018] [Indexed: 11/22/2022] Open
Abstract
Background The purpose of this survey was to determine the current trends in endovascular practice by Interventional Radiologists (IR’s) across Europe and to understand the engagement by Interventional Radiology (IR) with clinical practice. CIRSE European members were invited to participate in an online survey between July 11th, 2016 and August 8th, 2016. A 54 question survey was created to capture a comprehensive overview of IR endovascular practice and clinical engagement. Results Four hundred and five valid responses were received (9.9%) from a broad geographic distribution from across Europe. 76% of IR’s practised in centres with more than 400 beds as 60% worked in an academic or university teaching hospital. 36% dedicated 80–100% of their time to IR and 59% dedicated at least 60% of their time to IR. 24/7 IR on-call was available in the hospitals of 73% or respondents. 78% had dedicated IR nursing staff and 67% had nursing support on-call, 55% had inpatient admission privileges and 27% had dedicated IR inpatient beds. 65% of IR’s had admitting rights to day-case beds. 42% ran IR outpatient clinics and 36% performed ward rounds. 81% of respondents performed peripheral arterial disease (PAD) intervention and IR was the main provider of PAD intervention in 67% of centres. Vascular Surgery or Medicine were the main referrers (71%) to IR for PAD intervention. 37% of centres had a hybrid operating theatre and 80% of IR’s had access to this. Conclusion IR remains a substantial player in the field of PAD Intervention. The continued evolution of outpatient clinics and clinical practice is key to retention and future expansion in the field of endovascular therapy for PAD.
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Affiliation(s)
- Hong Kuan Kok
- 1Interventional Radiology Service, Department of Radiology, Northern Health, Melbourne, Australia.,2Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin 9, Ireland
| | - Thomas Rodt
- 3Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Fabrizio Fanelli
- 4Department of Vascular and Interventional Radiology, Careggi University Hospital, Florence, Italy
| | - Mohamad Hamady
- 5Department of Interventional Radiology, Imperial College, London, UK
| | - Stefan Müller-Hülsbeck
- Department of Diagnostic and Interventional Radiology, Ev.-Luth. Diakonissenanstalt zu Flensburg - Zentrum für Gesundheit und Diakonie, Flensburg, Germany
| | | | - Florian Wolf
- 8Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Michael J Lee
- 2Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin 9, Ireland
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Islam AM, Alreja G, Mallidi J, Ziaul Hoque M, Friderici J. Feasibility, safety, and patient satisfaction of same-day discharge following peripheral arterial interventions: A randomized controlled study. Catheter Cardiovasc Interv 2018. [DOI: 10.1002/ccd.27580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - Jaya Mallidi
- Baystate Medical Center; Springfield Massachusetts
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Chen CK, Boos J, Sarwar A, O'Bryan-Alberts B, Ahmed M, Brook OR. Observation time after outpatient non-arterial interventional procedures: standards, safety, and outcomes. Abdom Radiol (NY) 2017; 42:1571-1578. [PMID: 28097389 DOI: 10.1007/s00261-017-1046-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the impact of standardized reduced post-procedure observation time on subsequent healthcare encounters such as emergency department (ED) visits, hospital admissions, and clinic visits. METHODS 800 consecutive patients undergoing outpatient non-arterial interventional radiologic procedures within the vascular interventional department between 1 June 2013 and 21 July 2014 were included in this IRB-approved, HIPAA-compliant single center observational retrospective study. Electronic medical records were reviewed for subsequent healthcare encounters, such as ED visits, hospital admissions, and clinic visits. An attending interventional radiologist and radiology resident reviewed, in consensus, medical records for relevance of the encounter to the index procedure. Procedure-related encounters were analyzed to determine relationship to length of observation time, using Matlab for statistical analysis. RESULTS 397 and 403 patients were in the pre- and post-standardization groups, respectively. Median observation time decreased overall from 1.67 h [interquartile range (IQR) 1.17-2.17] to 1.42 h (IQR 1.08-1.92), p < 0.001. There was no significant change in either overall or procedure-related ED visits (16.6% [66/397] and 1.0% [4/397] pre-standardization vs. 20.1% [81/403] and 2.2% [9/403] post-standardization, p = 0.24 and 0.26), hospital admissions (27.7% [110/397] and 4.0% [16/397] prestandardization vs. 28.3% [114/403] and 2.7% [11/403] post-standardization, p = 0.88 and 0.33), or clinic visits (41.3% [164/397] and 1.0% [4/397] pre-standardization vs. 39.5% [159/403] and 2.2% [9/403] post-standardization, p = 0.61 and 0.26). CONCLUSION Proposed standardized shortened observation times after outpatient interventional radiologic procedures are safe, without change in either total or procedure-related ED visits, hospital admissions, or clinic visits.
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Affiliation(s)
- Christine K Chen
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA.
| | - Johannes Boos
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA
| | - Ammar Sarwar
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA
| | - Bridget O'Bryan-Alberts
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA
| | - Muneeb Ahmed
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA
| | - Olga R Brook
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA, 02215, USA
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Maher P. Same-day discharge after angioplasty for peripheral vascular disease: is it a safe and feasible option? JOURNAL OF VASCULAR NURSING 2016; 32:119-24. [PMID: 25131758 DOI: 10.1016/j.jvn.2014.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 12/31/2013] [Accepted: 01/03/2014] [Indexed: 10/24/2022]
Abstract
Peripheral vascular disease affects 20% of the population >55 years of age. Patients who become symptomatic are managed by a number of technique's including medical management, percutaneous angioplasty, bypass surgery, and in nonreconstructable situations, limb amputation. Clinicians treating patients by means of angioplasty have traditionally carried out these procedures on an inpatient basis. Limited resources and pressure on the availability of inpatient beds has necessitated clinicians to reevaluate how many of these patients are managed. Treating suitable patients as day cases is an attractive option that frees up resources and is financially advantageous. This paper examines the feasibility of same-day discharge after angioplasty, with a particular emphasis on achieving safe patient outcomes. It explores how advances in endovascular technologies and techniques have contributed to making same-day discharge an ever more feasible option. Nurse led pre-admission clinics run by specialist nurses facilitate safe and appropriate patient selection, where patients at risk for postprocedural problems can be identified effectively based on predefined clinical criteria.
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Affiliation(s)
- Paula Maher
- Trinity College and St. James Hospital, Dublin, Ireland.
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12
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Krokidis M. Peripheral angioplasty as a day case: science fiction or everyday reality? Expert Rev Cardiovasc Ther 2016; 14:775-7. [DOI: 10.1080/14779072.2016.1185367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Huang DY, Wilkins CJ, Evans DR, Ammar T, Deane C, Vas PR, Rashid H, Sidhu PS, Edmonds ME. The diabetic foot: the importance of coordinated care. Semin Intervent Radiol 2014; 31:307-12. [PMID: 25435655 DOI: 10.1055/s-0034-1393966] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Because of the severe morbidity and mortality associated with diabetes, diabetic foot care is an essential component of a peripheral vascular service. The goal of this article is to describe the vascular diabetic foot care pathway and how the coordinated foot care service for diabetic patients is delivered at King's College Hospital, London.
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Affiliation(s)
- Dean Y Huang
- Department of Radiology, King's College Hospital, London, United Kingdom
| | - C Jason Wilkins
- Department of Radiology, King's College Hospital, London, United Kingdom
| | - David R Evans
- Department of Radiology, King's College Hospital, London, United Kingdom
| | - Thoraya Ammar
- Department of Radiology, King's College Hospital, London, United Kingdom
| | - Colin Deane
- Vascular Laboratory, Department of Medical Engineering and Physics, King's College Hospital, London, United Kingdom
| | - Prashanth R Vas
- Department of Medicine, King's College Hospital, London, United Kingdom
| | - Hisham Rashid
- Department of Vascular Surgery, King's College Hospital, London, United Kingdom
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, London, United Kingdom
| | - Michael E Edmonds
- Department of Medicine, King's College Hospital, London, United Kingdom
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14
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Safety of endovascular treatment of chronic cerebrospinal venous insufficiency: a report of 240 patients with multiple sclerosis. J Vasc Interv Radiol 2011; 23:55-9. [PMID: 22088659 DOI: 10.1016/j.jvir.2011.09.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 09/19/2011] [Accepted: 09/20/2011] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the safety of outpatient endovascular treatment in patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI). MATERIALS AND METHODS A retrospective analysis was performed to assess complications occurring within 30 days of endovascular treatment of CCSVI. The study population comprised 240 patients; 257 procedures were performed over 8 months. The indication for treatment in all patients was symptomatic MS. Of the procedures, 49.0% (126 of 257) were performed in a hospital, and 51.0% (131 of 257) were performed in the office. Primary procedures accounted for 93.0% (239 of 257) of procedures, and repeat interventions accounted for 7% (18 of 257). For patients treated primarily, 87% (208 of 239) had angioplasty, and 11% (26 of 239) had stent placement; 5 patients were not treated. Of patients with restenosis, 50% (9 of 18) had angioplasty, and 50% (9 of 18) had stent placement. RESULTS After the procedure, all but three patients were discharged within 3 hours. Headache after the procedure was reported in 8.2% (21 of 257) of patients; headache persisted > 30 days in 1 patient. Neck pain was reported in 15.6% (40 of 257); 52.5% (21 of 40) of these patients underwent stent placement. Three patients experienced venous thrombosis requiring retreatment within 30 days. Sustained intraprocedural arrhythmias were observed in three patients, and two required hospital admission. One of these patients, who was being retreated for stent thrombosis, was hospitalized because of a stress-induced cardiomyopathy. CONCLUSIONS Endovascular treatment of CCSVI is a safe procedure; there is a 1.6% risk of major complications. Cardiac monitoring is essential to detect intraprocedural arrhythmias. Ultrasonography after the procedure is recommended to confirm venous patency and to identify patients experiencing acute venous thrombosis.
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Samson RH. Setting up an imaging center, adding computed tomographic, magnetic resonance, and an angiography suite to vascular labs. J Vasc Surg 2009; 49:1073-6. [DOI: 10.1016/j.jvs.2008.11.099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 11/17/2008] [Accepted: 11/21/2008] [Indexed: 10/20/2022]
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