Registry Evaluates 1-Day Discharge for Elderly Patients After Lower Extremity Endovascular Revascularization
October 10, 2017—Findings from the SENIOR-ER registry were recently published by Adam Janas, MD, et al online ahead of print in Catheterization and Cardiovascular Interventions. The registry aimed to assess safety and feasibility of early 1-day discharge after endovascular revascularization of the lower extremities in elderly patients.
The investigators reviewed consecutive data from 477 patients after endovascular revascularization who were intended for 1-day discharge. The endovascular procedure (balloon angioplasty, atherectomy, and stenting) was performed because of significant, angiographically confirmed arterial stenosis with at least Rutherford III claudication.
The population was divided into two groups: those ≥ 70 years of age (n = 235) and the control cohort of patients who were < 70 years of age (n = 220). Follow-up was performed at 24 hours after the procedure and at 30 days after discharge.
As summarized in Catheterization and Cardiovascular Interventions, the investigators found that there were no differences between the groups in the ratio of same-day discharge (99% vs 99.5%; P = .6). The mean time to ambulation was 287.4 ± 43.4 minutes versus 285.8 ± 45.7 minutes for the ≥ 70 years age group and < 70 years age group, respectively (P = .603).
The 1-day discharge was not applied in two patients in the ≥ 70 years age group because of two pseudoaneurysms requiring surgical repairs and because of retroperitoneal bleeding in one patient from the control group.
There was no major adverse cardiovascular event (MACE) or creatinine increase at 24 hours in both groups. At 30 days, there was no incidence of MACE in the ≥ 70 years age group versus three MACEs that occurred in the control group. The ratio of access site complications was comparable between the groups.
The study allows for a hypothesis that the advantages of 1-day discharge could be safely extended to the patients who are ≥70 years of age, concluded the investigators in Catheterization and Cardiovascular Interventions.