Safety and feasibility of same-day early discharge after endovascular revascularization of lower extremities in elderly. SENIOR-ER registry

Adam Janas, Krzysztof Milewski, Piotr P. Buszman, Ksenia Janas, Aleksandra Blachut, Maciej Pruski, Szymon Wiernek, Aleksander Zurakowski, Pawel E. Buszman, Stefan R. Kiesz

Research output: Contribution to journalArticle

Abstract

Objective: The aim of the study was to assess safety and feasibility of one-day early discharge (ODD) after endovascular revascularization (ER) of lower extremities in elderly. Background: Safety and feasibility of ODD after ER have never been investigated in the elderly, despite the PAD rate has been rising in well-developed countries as their populations are getting older. Methods: The consecutive data of 477 patients after ER who were intended to ODD were reviewed. The ER procedure (balloon angioplasty, atherectomy, stenting) was performed due to significant, angiographically confirmed arterial stenosis with at least Rutheford III claudication. The population was divided into two groups: ≥70 years old (y. o.) in which were 235 patients and 220 patients <70 y. o., the younger control cohort. The follow-up was performed 24 hr after (24FU) the procedure and 30 days (30FU) after discharge. Results: There were no differences between the groups in the ratio of same-day discharge (99% vs 99.5%, P = 0.6) and the mean time to ambulation was 287.4 ± 43.4 min versus 285.8 ± 45.7 min (P = 0.603). The ODD was not applied in 2 patients ≥70 y. o. due to two pseudoaneurysms requiring surgical repairs and in one from the control group due to retroperitoneal bleeding. There was no MACE or creatinine increase at 24 hr in both groups. At 30 days, there was no incidence of MACE in the ≥70 y. o. group while 3 MACE occurred in the control. The ratio of access site complications was comparable between the groups. Conclusion: The study allows for a hypothesis that the advantages of ODD could be safely extended to the patients ≥70 y. o.

Original languageEnglish (US)
Pages (from-to)515-520
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume91
Issue number3
DOIs
StatePublished - Feb 15 2018
Externally publishedYes

Keywords

  • aging
  • peripheral arterial disease
  • vascular access

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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