Shlofmitz Evan, Jeremias Allen, Goldberg Alec, Pappas Thomas, Berke Andrew, Petrossian George, Tsiamtsiouris Theofanis, Lituchy Andrew, Lee Michael, Shlofmitz Richard
St. Francis Hospital, Roslyn, NY, United States of America; Cardiovascular Research Foundation, New York, NY, United States of America; Columbia University Medical Center, New York, NY, United States of America.
St. Francis Hospital, Roslyn, NY, United States of America; Cardiovascular Research Foundation, New York, NY, United States of America.
Cardiovasc Revasc Med. 2019 Jul;20(7):573-576. doi: 10.1016/j.carrev.2018.09.002. Epub 2018 Sep 6.
Severely 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.
This 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.
There 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%).
SDD 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.
严重钙化病变给经皮冠状动脉介入治疗（PCI）带来诸多挑战。轨道旋磨术（OA）有助于严重钙化冠状动脉病变的血管准备和治疗。PCI术后当日出院（SDD）有诸多优势，包括节省费用和提高患者满意度。本研究旨在评估在实际临床环境中接受OA治疗的患者进行SDD的安全性。
这是一项对接受OA治疗患者的单中心回顾性分析。评估住院期间和30天内主要不良心脏事件（MACE）、器械相关事件和再次入院情况。
共有309例患者接受了OA治疗，其中94例（30.4%）实现当日出院。在当日出院患者中，无急性手术并发症，所有患者均在手术当日安全出院。30天时因胃动静脉畸形大出血导致1例患者发生MACE（1.06%）。有8例患者在30天内非计划再次入院（8.5%）。
严重钙化病变患者接受OA治疗后当日出院似乎是安全的，特定患者不良事件和再次入院发生率较低。接受OA治疗且当日出院的患者，非计划再次入院发生率与全州30天PCI再次入院平均发生率相似。需要开展更大规模研究以证实这种治疗模式的安全性及潜在的费用节省情况。
