| Title: | Safety and procedural success of daycase-based endovascular procedures in lower extremity arteries of patients with peripheral artery disease : a systematic review and meta-analysis |
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| Authors: | ID Hanna, Lydia (Author)
ID Rodway, Alexander D. (Author)
ID Garcha, Puneet (Author)
ID Maynard, Luci (Author)
ID Boc, Vinko (Author), et al. |
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| Files: |  PDF - Presentation file, download (1,91 MB)
MD5: 04243DD2FD5D9FE689A960A6B9E51448
 URL - Source URL, visit https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00367-5/fulltext
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | Background: Timely and economic provision of revascularisation procedures is a major healthcare need. We aimed to examine the safety and efficacy of daycase-based lower extremity endovascular revascularisation procedures in patients with peripheral artery disease. Methods: In this systematic review and meta-analysis, we searched MEDLINE and Embase for studies from Jan 01, 2000 through Apr 01, 2024 reporting complications of lower limb endovascular revascularisation procedures with same-day discharge. Eligibility-criteria, complications, and patient characteristics were extracted, methodological quality assessed (adapted Newcastle–Ottawa Scale), and meta-analyses of complications and technical success performed to provide pooled estimates. This study is registered with PROSPERO, CRD42022316466. Findings: Thirty observational studies (17 retrospective, 13 prospective) and 1 RCT reported 2427 minor and 653 major complications after 99,600 daycase procedures (93,344 patients). Eighteen studies reported daycase eligibility-criteria including ‘responsible adult companion’ (78%), ‘proximity to hospital’, and ‘telephone availability’ and excluding unstable and severe co-morbidities, offset coagulation, and severe chronic kidney disease. Pooled incidences of minor (4.7% [95% CI 3.8–5.6%], I 2 = 96%) and major (0.64% [95% CI 0.48–0.79%], I 2 = 46%) complications were low and technical success high (93% [95% CI 91–96%], I 2 = 97%). Most complications were related to the puncture site. Pooled conversion-to-hospitalisation rates and re-admission after discharge were 1.6% (95% CI 1.1–2.2%, I 2 = 82%) and 0.11% (95% CI 0.095–0.23%, I 2 = 97%), respectively. Meta-regression identified that minor complications decreased since 2000. Male sex and coronary artery disease were associated with more frequent, and higher age and closure device use with less minor complications. Diabetes mellitus and chronic kidney disease were associated with less major complications. Six studies reported complication rates both in daycases and inpatients and there was no significant difference (−0.8% [95% CI −1.9 to 0.3%]). Interpretation: After careful evaluation of eligibility, lower limb angioplasty can be performed safely with high technical success in a daycase setting. Most complications arise from the puncture site and not the procedure itself highlighting the importance of optimal access site management. The heterogeneity between studies warrants standardised monitoring of complications and outcomes. |
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| Keywords: | daycase angioplasty, chronic limb-threatening ischaemia, peripheral artery disease, endovascular, technical success |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2024 |
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| Number of pages: | str. 1-16 |
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| Numbering: | Vol. 75 |
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| PID: | 20.500.12556/DiRROS-24064  |
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| UDC: | 616.1 |
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| ISSN on article: | 2589-5370 |
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| DOI: | 10.1016/j.eclinm.2024.102788 |
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| COBISS.SI-ID: | 237921539 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 2. 6. 2025;
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| Publication date in DiRROS: | 10.11.2025 |
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| Views: | 126 |
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| Downloads: | 54 |
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