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The Inland Echo » Health » Coronary angioplasty now performed as outpatient ‘ambulatory’ service

Coronary angioplasty now performed as outpatient ‘ambulatory’ service


By Mariana Israel

Hospital Universitario Austral Future medicine is developing ambulatory techniques less and less invasive. Coronary angioplasty –a procedure used to open a blockage in a coronary artery– has been developed as well. “This technique is now very safe and predictable, basically due to the use of coronary stents, and the safe monitor of vascular access,” said Dr. Juan Manuel Telayna, chief of the Hemodynamic Service at Hospital Universitario Austral (HUA) in Buenos Aires, Argentina. At the health center, radial angioplasty –a procedure via an artery in the person’s wrist– has been started to be performed, instead of femoral angioplasty –a procedure via an artery in the person’s leg. “The objective is to perform the procedure in an ambulatory fashion. The femoral approach requires that the patient should stay the night at the hospital. But with this new technique, the patient can be discharged in a few hours,” said Dr. Telayna.

The advantage here is that the patient can be discharged from the health center in a few hours.“This technique is specially chosen by those who are now familiarized with the concept of ‘ambulatory surgery,’ which involves being discharged without having to spend the night at the hospital, a situation increasingly resisted by patients,” he added. In addition to this, from the point of view of the institution, the specialist said that “another advantage of this minimally invasive procedure is that we can optimize bed management. Both admission and discharge of patients are managed directly by the Hemodynamic Service, which has only one ward with four beds next to where catheterism is performed.”

“This approach makes the difference when it is about offering people high quality service and best development standards. People often say: ‘Doctor, I came to the HUA because here I have the angioplasty done via my arm, I can walk again immediately and, in the afternoon, go back home.’ This is what patients expect,” said Dr. Telayna.

First in the Country

This is a new technique since it is being performed at some places in the United States, and regionally at a health center in Chile. This year at the HUA, the Hemodynamic Service wrote a protocol to perform the procedure, which was approved by the Institution’s Ethics Committee. Said protocol follows strict inclusion and exclusion criteria. “Only patients carefully elected can undergo an ambulatory angioplasty. This is a new alternative that can be taken into account as long as the risk is low according to the clinical and angiographic examination,” warned the chief of the Service.

“Up to now, the experience has been very successful and highly positive,” concluded the specialist. About 20% of the patients we see at the Hospital can benefit from this approach.

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Submitted by Michael Breckenridge

Editor and chief photographer of the Inland Echo.

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