| Long-term postplacement cost comparison of AneuRx and Zenith endografts. | |
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MedLine Citation:
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PMID: 18783917 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Long-term postplacement costs increase the global cost of endovascular aneurysm repair (EVAR) by 44%. Secondary procedures and endoleaks significantly increase long-term expense. This study evaluates device-specific long-term postplacement costs using two different endografts. AneuRx and Zenith endografts were used to treat 250 patients with abdominal aortic aneurysms between December 1998 and June 2006 at a single institution. A relative value unit-based hospital cost accounting system was used to calculate both direct and indirect hospital departmental costs. Institutional overhead expenses, costs of professional services, and outpatient visits were also included in cost determinations. All costs were valued in 2006 dollars. To examine long-term costs, patients with <1 year follow-up were excluded. The initial 50 EVAR patients between December 1995 and 1998 were also excluded, to limit the effect of the learning curve on postplacement cost. The cumulative 5-year postplacement costs per patient were $12,465 (AneuRx) and $10,606 (Zenith, p = 0.22). Mean durations of follow-up were 38.5 +/- 5.2 months (AneuRx) and 32.8 +/- 3.8 months (Zenith, p = 0.12). For both devices, the largest cost components were secondary procedures (59.5% AneuRx vs. 56.4% Zenith) and radiologic studies (29.2% AneuRx vs. 34.9% Zenith). Freedom from secondary procedures (80% vs. 51%, p < 0.05) and endoleaks (83% vs. 58%, p = 0.05) was higher in patients treated with Zenith vs. AneuRx endografts, respectively. There was a reduction in secondary procedures and endoleaks in patients treated with Zenith compared to AneuRx. The corresponding 15% reduction in cost, however, was not statistically significant. Additional device-related cost reductions may be possible through improvements in device and technique and alterations in surveillance imaging. |
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Authors:
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Robert E Noll; Britt H Tonnessen; Jason Kim; Samuel R Money; W Charles Sternbergh |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-09-09 |
Journal Detail:
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Title: Annals of vascular surgery Volume: 22 ISSN: 1615-5947 ISO Abbreviation: Ann Vasc Surg Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-11-10 Completed Date: 2009-01-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 710-5 Citation Subset: IM |
Affiliation:
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Section of Vascular Surgery, Ochsner Clinic Foundation, New Orleans, LA 70121, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aortic Aneurysm, Abdominal / economics*, radiography, therapy* Aortography / economics Blood Vessel Prosthesis / economics* Blood Vessel Prosthesis Implantation / adverse effects, economics*, instrumentation* Cost-Benefit Analysis Female Hospital Costs* Humans Male Prosthesis Design Prosthesis Failure Reoperation / economics Retrospective Studies Stents / economics* Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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