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First published online March 17, 2008
British Journal of Radiology (2008) 81, 537-544
© 2008 British Institute of Radiology
doi: 10.1259/bjr/54749779
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Full paper

Day-case diagnostic and interventional peripheral angiography: 10-year experience in a radiology specialist nurse-led unit

D Y HUANG, MRCPCH, FRCR1, C-M ONG, RSN, H L WALTERS, MRCP, FRCR1, C J WILKINS, MRCP, FRCR1, D R EVANS, FRCS, MRCP1, R D EDMONDSON, MS, FRCR2, K JONES, FRCS2, H I RASHID, MS, FRCS2, C D DEANE, PhD3, D E GOSS, PhD3 and P S SIDHU, BSc, MRCP, FRCR1

Departments of 1 Radiology, 2 Vascular Surgery and 3 Vascular Laboratory, King's College Hospital, Denmark Hill, London SE5 9RS, UK

Correspondence: Paul Sidhu, Department of Radiology, King's College Hospital, Denmark Hill, London SE5 9RS, UK. E-mail: paul.sidhu{at}kch.nhs.uk

We describe a prospective evaluation of the safety of peripheral angiography procedures performed on day-case patients in a dedicated radiological nurse-led and administrated unit. Patients referred for peripheral vascular angiography, over a 10-year period, were pre-assessed by a radiology specialist nurse in a nurse-led clinic. Radiologists performed all procedures, whereas radiology specialist nurses were responsible for patient care before, during and after angiography and during the 24 h follow-up. Procedures were divided into diagnostic or interventional; complications were divided into immediate or delayed (24 h follow-up) either requiring hospital admission (major) or day-case unit management (minor). Patient acceptability was assessed using a standard questionnaire. Cost analysis was also performed. 401 day-case peripheral angiography procedures (144 diagnostic and 257 interventional) were performed in 310 patients. 109/401 (27.2%) procedures were performed on patients with diabetes mellitus. In diagnostic studies, 16/144 (11.1%) immediate and 6/144 (4.2%) delayed complications occurred whereas, in interventional studies, 65/257 (25.3%) immediate and 13/257 (5.1%) delayed complications were noted. A major complication occurred in 17/257 (6.6%) of patients in the interventional group and 3/144 (2.1%) in the diagnostic group. Puncture site haematoma was the most common complication. Nurse-led care was acceptable to the patient, with a high level of patient satisfaction seen. In conclusion, day-case diagnostic and interventional peripheral angiography procedures can be performed safely in a specialist nurse-led and administrated unit, with complication rates being within the accepted guidelines.






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