Feasibility and Safety of Same‐Day Discharge Following Complex PCI: Sub‐Analysis From a Dedicated Same‐Day Discharge Radial Lounge Program

INTRODUCTION: Same-day discharge (SDD) following percutaneous coronary intervention (PCI) is a safe and efficient strategy, especially within dedicated care models like the Radial Lounge. While SDD is well established for standard elective PCI, evidence for its use in complex cases is limited. This sub-analysis evaluated the safety and feasibility of SDD in patients undergoing complex PCI within a structured SDD framework. AIMS: To assess the incidence of major adverse cardiac events (MACEs)-including in-hospital mortality, 30-day mortality, and 30-day readmission-in patients undergoing complex PCI with SDD, compared to non-complex PCI cases. METHODS: We retrospectively analyzed elective SDD PCI cases performed between 2015 and 2023 at a single center. Complex PCI was defined by anatomical and procedural criteria, including left main or proximal LAD interventions, saphenous vein grafts, chronic total occlusions, bifurcations, Syntax score > 33, and use of IVUS or Rotablator. Outcomes were compared between complex and non-complex PCI groups. The primary endpoint was 30-day MACE. RESULTS: Of 3725 elective SDD PCIs, 1671 were complex. No significant differences were observed in in-hospital mortality (0.23% vs. 0.19%), 30-day mortality (0% in both), or readmissions. Complex PCI patients had higher rates of diabetes, prior PCI, femoral access, and multivessel interventions. Radial access was more frequent in the non-complex group. The most common complexity criteria were proximal LAD and bifurcations. CONCLUSIONS: SDD is a feasible and safe approach for selected complex PCI cases when implemented within a structured care model, supporting broader adoption of SDD protocols to optimize resource utilization without compromising safety.