A study of PCI in ASC settings published November 9 in JACC: Cardiovascular Interventions found significantly increased bleeding complications in propensity-matched analysis (OR: 2.49; 95% CI: 1.25 to 4.95; p = 0.009). “Commercially insured patients undergoing ASC PCI were less likely to undergo fractional flow reserve testing and had higher odds of bleeding complications,” than patients treated in a hospital outpatient department, concludes the study authors.
In an editorial accompanying this study, Gregory J. Dehmer, MD argued, “this study should be a warning, not necessarily to stop or change course, but rather to proceed with caution.” Because of its largely unproven nature, especially in the Medicare population, “Performing PCI in an ASC environment requires strict adherence to regulatory requirements and operational recommendations,” he wrote.