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Objective: To assess the safety of endovascular procedures in office setting over a long term period.Methods: Between 5/22/2005 and 11/22/2011, 2309 patients had 5029 percutaneous procedures carried out in an office based procedural suite. Demographics of the patients, complications, hospital transfers were documented in a prospective manner. Follow up calls were made and a satisfaction survey was carried out. Most procedures were carried out under a local anesthesia or conscious sedation. All patients, except the ones having catheter removal, received acetaminophen and hydrocodone 5/500, diazepam 5 - 10 mg, one dose of an oral antibiotic pre- procedure and three doses post procedure. Patients requiring conscious sedation received fentanyl and midazolam. Conscious sedation was used in patients having peripheral arterial interventions. BUN, creatinine, INR and PTT were performed prior to peripheral arteriograms. Patients on dialysis (ESRD) had no lab work done pre-operatively. Patients considered high risk, those who could not tolerate the procedure with mild to moderate conscious sedation or those who were morbidly obese, were not candidates for office based procedures.
Results: There was no procedure related mortality. Procedures and complications are listed in table "A". There were 45 total complications (0.9%) of which 20 (0.4%) were site related, 14 (0.3%) were DVT following venous procedure and 11 (0.2%) were other medical problems. Seventeen procedures required subsequent hospital transfer. Ninety nine percent of patients surveyed indicated that they would come back to the office for needed procedures.
Conclusions: When appropriately screened, almost all peripheral interventions can be carried out in the office with minimal complications. For dialysis patients outpatient intervention has a very low complication rate and is the mainstay of treatment to keep the dialysis access patent. Venous insufficiency when managed in the office setting also has a low complication rate. Office based procedural settings should be the preferred site for percutaneous interventions for arterial, venous and dialysis related procedures.
Table "A"
Office Based Procedural Complications
5/22/2005 - 11/22/2011

Procedure	Number of Procedures	Total Complications	Site Related Complications	Medical Complications	D.V.T.	Hospital Transfers
Arteriogram with runoff	422	6	5	1		2
* Arteriogram with intervention	325	7	6	1		5
Fistulogram	162	1		1		1
** Fistulogram intervention	1375	2	1	1		1
Fistulogram with thrombectomy of dialysis access	498	7	3	4		6
EVLT	313	8		2	6
EVLT & micro	427	9	2		7
Microphlebectomy	110	2	1		1
Catheter insertion	329	2	2			1
Catheter exchange	229
Catheter gram	4
Catheter removal	628
Powerport	111
Powerport removal	15
Venogram	43
Venoplasty	5
IVC filter insertion	4	1		1		1
IVC filter removal	29

* Arteriogram interventions include - angioplasty, coiling, stenting, atherectomy
** Fistulogram interventions include - angioplasty, coiling, stenting