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Cost Comparison of Endovascular Treatment of Anterior Circulation Aneurysms with the Pipeline Embolization Device Versus Stent-Assisted Coiling.
MedLine Citation:
PMID:  22806083     Owner:  NLM     Status:  Publisher    
BACKGROUND:: The Pipeline embolization device (PED) is a new endovascular option for wide-necked or fusiform anterior circulation aneurysms that were classically treated by coil embolization with adjunctive use of a stent. However, stent-coiling incurs significant equipment and implant costs. OBJECTIVE:: To determine if procedure costs for PED embolization are more economical than stent-assisted coiling. METHODS:: Sixty consecutive patients with anterior circulation aneurysms who underwent treatment with the PED (30 patients) or by single-staged stent-assisted coiling (30 patients) were identified from a prospective single-center aneurysm database. The hospital cost of equipment and implants were analyzed and compared for each group. RESULTS:: The mean aneurysm size for patients treated with the PED was 9.8 mm versus 7.3 mm for patients treated by stent-assisted coiling. The total combined cost of proximal access/guide catheters, microcatheters, and microwires were equivalent between the 2 groups. The cost of implants, however, was significantly lower in the PED group ($13,175 ± $726 versus $19,069 ± $2,015, p= 0.013), despite this group having a larger mean aneurysm size. Furthermore, the total procedure cost was significantly lower for the PED group versus the stent-coiling group ($16,445 ± $735 versus $22,145 ± $2,022, p=0.018), a 25.7% cost reduction. This represents a 27.1% reduction in the cost per millimeter of aneurysm treated in the PED group ($2,261 ± $299) versus the stent-coiling group ($3,102 ± $193, p=0.02). CONCLUSION:: Treatment of anterior circulation aneurysms by flow diversion with the PED has lower procedure costs as compared to traditional stent-assisted coiling.
Geoffrey P Colby; Li-Mei Lin; Alexandra R Paul; Judy Huang; Rafael J Tamargo; Alexander L Coon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-16
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital 2Division of Neurosurgery, Albany Medical Center Hospital.
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