医学
镇静
回廊的
咪唑安定
血管造影
脑血管造影
神经外科
患者安全
患者满意度
单中心
外科
急诊医学
麻醉
医疗保健
经济
经济增长
作者
Tyler Scullen,Ming X. Lian,Vinay Jaikumar,Jennifer L. Gay,Pui Man Rosalind Lai,Matthew J. McPheeters,Steven B. Housley,Kunal P. Raygor,Mehdi Bouslama,Hamid S. Khan,Adnan H. Siddiqui,Jason M. Davies,Douglas B. Moreland,Elad I. Levy
出处
期刊:Neurosurgery
[Lippincott Williams & Wilkins]
日期:2024-07-23
被引量:3
标识
DOI:10.1227/neu.0000000000003119
摘要
BACKGROUND AND OBJECTIVE: Ambulatory surgery centers (ASCs) are increasingly common venues for same-day neurosurgical procedures, allowing for cost-effective, high-quality patient care. We present the first and largest series of patients undergoing diagnostic cerebral angiography at an ASC to demonstrate the effectiveness, safety, and efficiency of outpatient endovascular care. METHODS: We retrospectively reviewed data for consecutive patients who underwent diagnostic cerebral angiography at our ASC between January 1, 2024, and May 29, 2024. Data collected included vascular access approach, procedural duration, turnover time, and periprocedural complications. Using a standardized 2-week postprocedural survey, patients were asked to provide comments and rate their subjective satisfaction from a 1 to 5 scale, with “5” being completely satisfied. All cases were performed with a physician team comprising 1 attending neuroendovascular neurosurgery and 1 neuroendovascular fellow present. Fentanyl and midazolam were administered for conscious sedation in all cases. RESULTS: Among the 67 patients included in this series, the mean procedural duration was 29.4 ± 8.6 minutes. The mean turnover time was 13.7 ± 3.6 minutes. Between transradial (46 of 67 [68.7%]) and transfemoral (21 of 67 [31.3%]) access site approaches, there were no statistically significant differences in mean procedural duration (29.4 ± 8.0 vs 29.2 ± 9.9 minutes, respectively; P = .72) or turnover time (14.0 ± 3.9 vs 12.9 ± 2.8 minutes, respectively; P = .4). No complications occurred periprocedurally or within the 2-week follow-up period. A total of 48 (71.6%) of 67 patients responded to the postprocedural survey, all of whom unanimously reported a score of “5.” CONCLUSION: We found that diagnostic cerebral angiography performed at our ASC was safe and effective for patient care. In addition, all survey respondents (71.6% of those provided the survey) reported highest levels of satisfaction. The integration of neuroendovascular procedures into ASCs potentially offers a cost-effective and highly efficient option in an evolving economic landscape.
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