Safety of Same-Day Discharge after Percutaneous Coronary Intervention with Orbital Atherectomy |
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| Institution: | 1. St. Francis Hospital, Roslyn, NY, United States of America;2. Cardiovascular Research Foundation, New York, NY, United States of America;3. Columbia University Medical Center, New York, NY, United States of America;4. UCLA Medical Center, Los Angeles, CA, United States of America;1. Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;2. Department of Modern Sciences & Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;3. Department of Genetics, Faculty of Medicine and Genetics Laboratory, AL Zahra Hospital, Isfahan University of Medicine, Isfahan, Iran;4. Isfahan Cardiovascular Research Institute, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;5. Department of Clinical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;6. Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.;7. Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;8. Assistant Professor, Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;9. Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;10. Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;11. Supervisor of Heart Center, Sa''adi Hospital, Isfahan, Iran;12. Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK |
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| Abstract: | BackgroundSeverely calcified lesions present many challenges to percutaneous coronary intervention (PCI). Orbital atherectomy (OA) aids vessel preparation and treatment of severely calcified coronary lesions. Same-day discharge (SDD) after PCI has numerous advantages including cost savings and improved patient satisfaction. The aim of this study is to evaluate the safety of SDD among patients treated with OA in a real-world setting.MethodsThis was a single-center retrospective analysis of patients undergoing OA. In-hospital and 30-day outcomes were assessed for major adverse cardiac events (MACE), device-related events and hospital readmissions.ResultsThere were 309 patients treated with OA of whom 94 had SDD (30.4%). Among SDD patients, there were no acute procedural complications and all patients were safely discharged on the day of the procedure. MACE at 30 days occurred in 1 patient (1.06%) due to major bleeding in the setting of a gastric arteriovenous malformation. There were 8 patients with unplanned 30-day readmissions (8.5%).ConclusionSDD after OA in patients with heavily calcified lesions appears to be safe, with low rates of adverse events and readmissions in select patients. In patients with SDD treated with OA, unplanned readmission occurred at a similar rate to the statewide average 30-day PCI readmission rate. Larger studies are needed to confirm the safety of this treatment paradigm and the potential cost savings. |
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