- The Washington Times - Tuesday, November 15, 2005

DALLAS (AP) — More patients going to hospitals to get their heart arteries unclogged are going home the same day.

New research presented Sunday at an American Heart Association conference suggests the approach is safe. It found complications were no greater in persons who went home a few hours after having angioplasty than in those who were hospitalized overnight.

Doctors have been reluctant to adopt the outpatient method, but “this is the kind of study that’s going to turn the trend,” said Dr. Timothy Gardner, a Delaware cardiologist.

“Insurers are getting cranky” about hospital costs and will be enthused about ways to cut them, he said.

Patients, however, might not like being rushed out the door. Some may view it as the cardiac equivalent of “drive-through deliveries,” where new moms are sent home the day they give birth.

Angioplasty is one of the most common medical techniques in the world. About 600,000 are done each year in the United States alone.

Through an artery in the leg near the groin, doctors snake a tube to blockages that are clogging vessels and preventing them from supplying enough blood to the heart. A tiny balloon is inflated to flatten the deposit, and a mesh scaffold called a stent is left behind to prop the artery open.

Two kinds of complications can occur: bleeding from the leg incision and reclogging of the heart artery.

To avoid the first type, Canadian researchers did angioplasty a different way — using an artery in the arm near the wrist instead of one in the leg, which greatly reduces bleeding.

Next, they tested the need to keep patients overnight by giving half of those in the study a single dose of anti-clotting medication and sending them home 4 to 6 hours afterward. The other half got standard treatment: the single dose plus a 12-hour intravenous one given overnight in the hospital.

Six months later, the rates of major bleeding, heart attacks or need for repeat procedures to treat blockages were nearly identical in the two groups: 30 among the 504 patients given the single drug dose versus 28 in the other 501.

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