Diethrich Edward B., Kinard Sam A., Pierce Stephen A., Koopot Ravi
Section of Cardiovascular Surgery, Section of Cardiology, and the Invasive Procedures Laboratory, Arizona Heart Institute, Phoenix, Arizona.
Cardiovasc Dis. 1981 Jun;8(2):195-204.
Arteriographic examination of the coronary, cerebral, and peripheral circulatory systems is the ultimate diagnostic technique for the identification and quantification of atherosclerotic occlusive disease. In the past, hospitalization has been required for this invasive procedure. Recently, however, the concept of outpatient catheterization and arteriography has become a reality. To investigate the integrity, safety, and cost-effectiveness of our outpatient invasive procedures laboratory, we analyzed our experience with 254 cardiac catheterizations and 174 peripheral arteriograms performed during a 20-month period. There were no deaths or major complications. Minor complications (11%) included bleeding from the cutdown site, nausea, numbness, and allergic reactions. Two patients with arrhythmias required cardioversion. Nine patients (2%) were transferred to the hospital for observation or immediate surgery due to the nature of their atherosclerotic lesions. This study reveals (1) the technical quality, safety, indications, and contraindications for outpatient catheterization and arteriography; (2) the enthusiastic patient acceptance of outpatient invasive diagnostic studies; (3) the economic impact of these procedures on escalating health-care costs; and (4) the potential for outpatient catheterization and arteriography on a broad scale.
对冠状动脉、脑血管和外周循环系统进行动脉造影检查是识别和量化动脉粥样硬化闭塞性疾病的最终诊断技术。过去,这种侵入性检查需要住院进行。然而,近年来,门诊导管插入术和动脉造影术的概念已成为现实。为了研究我们门诊侵入性检查实验室的完整性、安全性和成本效益,我们分析了在20个月内进行的254例心脏导管插入术和174例外周动脉造影的经验。未发生死亡或重大并发症。轻微并发症(11%)包括切开部位出血、恶心、麻木和过敏反应。两名心律失常患者需要进行心脏复律。9名患者(2%)因动脉粥样硬化病变的性质被转至医院观察或立即手术。本研究揭示了:(1)门诊导管插入术和动脉造影的技术质量、安全性、适应证和禁忌证;(2)患者对门诊侵入性诊断检查的积极接受程度;(3)这些检查对不断攀升的医疗费用的经济影响;(4)门诊导管插入术和动脉造影广泛应用的潜力。