Study: Outpatient PCI safety comparable for ASCs, HOPDs

Editor's Note

The first study to evaluate percutaneous coronary interventions (PCI) in Medicare beneficiaries treated at ambulatory surgery centers (ASCs) found similar short-term safety outcomes as hospital outpatient departments (HOPDs). As detailed in an announcement from The Society for Cardiovascular Angiography & Interventions (SCAI), the research was presented on May 1 at the SCAI 2025 Scientific Sessions in Washington, DC.

Although PCI outside traditional hospital settings has become more common since Medicare began covering certain procedures in 2020, little is known about the patient and procedural characteristics and outcomes of PCI in ASCs, SCAI notes. To help close the knowledge gap, researchers analyzed 408,060 Medicare claims from 2020 to 2022 and found that just under 2% of outpatient PCI procedures occurred in ASCs. While overall ASC volume was low, the growth was significant, rising from 0.01 to 0.87 per 10,000 person-years between 2018 and 2022. Patients treated at ASCs were more likely to live in the Southern US and in socially vulnerable communities, based on the CDC’s Social Vulnerability Index. They were also less likely to receive multivessel PCI (3% in ASCs vs 5.9% in hospital outpatient departments).

At 30 days, adverse outcomes—including mortality, stroke, tamponade, and access-site bleeding—were comparable between ASCs and HOPD settings. However, patients treated in outpatient hospital settings experienced more all-cause hospitalizations and acute myocardial infarctions, while ASC patients had a higher rate of repeat PCI procedures (odds ratio 2.14).

The authors noted that appropriate patient selection is likely contributing to the comparable safety outcomes. The study calls for broader participation in national quality registries to help define benchmarks that reflect the specific risk profile of ASC-treated patients.