Feasibility of Ambulatory Carotid Artery Stenting
Background: Ambulatory procedures have been shown to increase patient’s comfort and cost-efficacy. We sought to determine the feasibility of ambulatory carotid stenting in a series of patients undergoing the procedure. Methods: Patients were electively admitted and discharged the same-day if they had successful uncomplicated carotid stenting and had demonstrated complete vascular access site hemostasis following ambulation 4–6 hours after the procedure. Patients were followed for neurological events and vascular access site complications. Results: A total of 76 same-day carotid stenting procedures were performed on 73 patients (76 arteries). There were 53 (73 %) males and the mean age was 70 ± 8 years. Seventy-nine percent of the patients were asymptomatic on presentation. Fourteen patients (18 %) had prior ipsilateral CEA, 3 (4%) had prior ipsilateral neck radiation and 6 (8 %) had contralateral occlusions. Successful access site hemostasis was achieved in all patients, using suture-mediated vascular sealing devices in 75 cases (99%). In one case hemostasis was achieved manually after failure of the sealing device. Late follow-up currently available on 62 (98%) patients at a mean of 4 ± 3 months. There have been no neurological events, deaths, repeat procedures or significant access site complications. One patient developed serous discharge from the access site at 6 weeks without evidence of infection or hematoma and was managed conservatively without complications. Conclusion: Ambulatory carotid stenting is feasible and safe. This approach will foster the applicability of the procedure by increasing patient s comfort and potentially reducing procedural costs.