Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions

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Abstract

Since the publication of the 2009 SCAI Expert Consensus Document on Length of Stay Following percutaneous coronary intervention (PCI), advances in vascular access techniques, stent technology, and antiplatelet pharmacology have facilitated changes in discharge patterns following PCI. Additional clinical studies have demonstrated the safety of early and same day discharge in selected patients with uncomplicated PCI, while reimbursement policies have discouraged unnecessary hospitalization. This consensus update: (1) clarifies clinical and reimbursement definitions of discharge strategies, (2) reviews the technological advances and literature supporting reduced hospitalization duration and risk assessment, and (3) describes changes to the consensus recommendations on length of stay following PCI (Supporting Information Table S1). These recommendations are intended to support reasonable clinical decision making regarding postprocedure length of stay for a broad spectrum of patients undergoing PCI, rather than prescribing a specific period of observation for individual patients.

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Most cited references 34

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Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials.

Giuseppe Ferrante, Sunil V Rao, Peter Jüni … (2016)

The aim of this study was to provide a quantitative appraisal of the effects on clinical outcomes of radial access for coronary interventions in patients with coronary artery disease (CAD).

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Lower risk of stent thrombosis and restenosis with unrestricted use of 'new-generation' drug-eluting stents: a report from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR).

Mansoor N Saleh, Göran Olivecrona, Dimitris Venetzanos … (2012)

To compare the long-term outcome after percutaneous coronary intervention with 'new-generation' drug-eluting stents (n-DES) to 'older generation' DES (o-DES), and bare-metal stents (BMS) in a real-world population. We evaluated 94 384 consecutive stent implantations (BMS, n = 64 631; o-DES, n = 19 202; n-DES, n = 10 551) in Sweden from November 2006 to October 2010. All cases of definite stent thrombosis (ST) and restenosis were documented in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Older generation DES were classified as: Cypher and Cypher Select (Cordis Corporation, Miami, FL, USA), Taxus Express and Taxus Liberté (Boston Scientific Corporation), and Endeavor (Medtronic Inc.) and n-DES as: Endeavor Resolute (Medtronic Inc.), XienceV, Xience Prime (Abbott Laboratories) and Promus, Promus Element (Boston Scientific Corporation). The Cox regression analyses unadjusted and adjusted for clinical and angiographic covariates showed a statistically significant lower risk of restenosis in n-DES compared with BMS [adjusted hazard ratio (HR) 0.29; 95% confidence interval (CI): 0.25-0.33] and o-DES (HR 0.62; 95% CI: 0.53-0.72). A lower risk of definite ST was found in n-DES compared with BMS (HR 0.38; 95% CI: 0.28-0.52) and o-DES (HR, 0.57; 95% CI: 0.41-0.79). The risk of death was significantly lower in n-DES compared with o-DES (adjusted HR: 0.77; 95% CI: 0.63-0.95) and BMS (adjusted HR: 0.55; 95% CI: 0.46-0.67). Percutaneous coronary intervention with n-DES is associated with a 38% lower risk of clinically meaningful restenosis, a 43% lower risk of definite ST, and a 23% lower risk of death compared with o-DES in this observational study from a large real-world population.

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An updated bleeding model to predict the risk of post-procedure bleeding among patients undergoing percutaneous coronary intervention: a report using an expanded bleeding definition from the National Cardiovascular Data Registry CathPCI Registry.

Sunil V Rao, Lisa McCoy, John Spertus … (2013)

This study sought to develop a model that predicts bleeding complications using an expanded bleeding definition among patients undergoing percutaneous coronary intervention (PCI) in contemporary clinical practice.

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Author and article information

Contributors

Arnold H. Seto: (View ORCID Profile)

Mazen Abu-Fadel: (View ORCID Profile)

James C. Blankenship: (View ORCID Profile)

Joaquin E. Cigarroa: (View ORCID Profile)

Kusum Lata: (View ORCID Profile)

Rajesh V. Swaminathan: (View ORCID Profile)

Journal

Title: Catheterization and Cardiovascular Interventions

Abbreviated Title: Catheter Cardiovasc Interv

Publisher: Wiley

ISSN: 15221946

Publication date Created: October 01 2018

Publication date (Print): October 01 2018

Publication date (Electronic): April 24 2018

Volume: 92

Issue: 4

Pages: 717-731

Affiliations

[1 ]Department of Medicine; Long Beach Veterans Affairs Healthcare System, Long Beach, California

[2 ]Department of Medicine; University of Illinois at Chicago, Chicago, Illinois

[3 ]Department of Internal Medicine, Section of Cardiovascular Medicine; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

[4 ]Department of Cardiology, Section of Interventional Cardiology; Geisinger Medical Center, Danville, Pennsylvania

[5 ]Department of Medicine/Cardiovascular Medicine; The Ohio State University, Ohio

[6 ]Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon

[7 ]Department of Medicine (Cardiology Division) Texas A&M University College of Medicine; Scott & White Medical Center; Temple Texas

[8 ]New York-Presbyterian Hospital; Weill Cornell Medical College; New York New York

[9 ]Cardiovascular Medicine Division; University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

[10 ]Sutter Tracy Community Hospital, Sutter Medical Network, Tracy, California

[11 ]Division of Cardiology; Duke Clinical Research Institute, Durham, North Carolina

Article

DOI: 10.1002/ccd.27637

PubMed ID: 29691963

SO-VID: c741839c-c998-417e-87a3-b247cbdd7f75

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http://doi.wiley.com/10.1002/tdm_license_1.1

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Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions

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Most cited references 34

Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials.

Lower risk of stent thrombosis and restenosis with unrestricted use of 'new-generation' drug-eluting stents: a report from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR).

An updated bleeding model to predict the risk of post-procedure bleeding among patients undergoing percutaneous coronary intervention: a report using an expanded bleeding definition from the National Cardiovascular Data Registry CathPCI Registry.

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