Same day discharge following elective percutaneous coronary intervention in patients with stable angina

With current stent technology and potent antiplatelet drugs, the results of percutaneous coronary intervention (PCI) are increasingly predictable. Kiemeneij and colleagues1 first described PCI as a daycase procedure done via the radial artery, though nearly 50% of these patients were considered unsuitable for same day discharge post-procedure. Subsequently, Koch and colleagues2 performed PCI on > 1000 patients via the femoral artery, transferring more than 90% the same day, back to their referring non-interventional hospital for overnight observation. In the UK, pressure on elective beds causes procedure cancellations and long waiting lists. Performing PCI as a day case procedure minimises the problems of bed availability and reduces overall cost. In 1999 we initiated a policy of elective PCI using coronary stenting and femoral artery access with same day discharge from hospital. During a two year period, 487 patients underwent day case PCI and we report on their immediate and six month outcomes. Between 1 February 1999 and 1 February 2001, our institution performed 1964 PCI procedures. A total of 487 patients with stable angina were admitted electively for PCI with planned same day discharge. Cases not considered for day case procedures included patients with acute coronary syndromes, patients with adverse angiographic appearances including bifurcations, small vessels (< 3 mm), diffuse disease, and lesions unsuitable for stenting. Cases where glycoprotein IIb/IIIa …