| A cost-effectiveness analysis of carotid artery stenting compared with endarterectomy. | |
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MedLine Citation:
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PMID: 20816349 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Endarterectomy and angioplasty with stenting have emerged as 2 alternative treatments for carotid artery stenosis. This study's objective was to determine the cost-effectiveness of carotid artery stenting (CAS) compared with carotid endarterectomy (CEA) in symptomatic subjects who are suitable for either intervention. A Markov analysis of these 2 revascularization procedures was conducted using direct Medicare costs (2007 US$) and characteristics of a symptomatic 70-year-old cohort over a lifetime. In the base case analysis, CAS produced 8.97 quality-adjusted life-years, compared with 9.64 quality-adjusted life-years for CEA. The incremental cost of stenting was $17,700, and thus CAS was dominated by CEA. Sensitivity analyses show that the long-term probabilities of major stroke or mortality influenced the results. In the base case analysis, CEA for patients with symptomatic stenosis has a greater benefit than CAS, with lower direct costs. With 59% probability, CEA will be the optimal intervention when all of the model assumptions are varied simultaneously. |
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Authors:
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Kate C Young; Robert G Holloway; W Scott Burgin; Curtis G Benesch |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association Volume: 19 ISSN: 1532-8511 ISO Abbreviation: J Stroke Cerebrovasc Dis Publication Date: 2010 Sep-Oct |
Date Detail:
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Created Date: 2010-09-06 Completed Date: 2011-01-13 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 9111633 Medline TA: J Stroke Cerebrovasc Dis Country: United States |
Other Details:
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Languages: eng Pagination: 404-9 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 National Stroke Association. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA. kate_young@urmc.rochester.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angioplasty / economics*, instrumentation, methods Carotid Stenosis / economics, therapy* Cohort Studies Cost-Benefit Analysis Decision Trees Endarterectomy, Carotid / economics*, methods Humans Markov Chains Models, Economic Quality-Adjusted Life Years* Stents / economics Stroke / prevention & control* |
| Grant Support | |
ID/Acronym/Agency:
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1UL1RR024160-01/RR/NCRR NIH HHS; K24 NS042098-05/NS/NINDS NIH HHS; K24NS42098/NS/NINDS NIH HHS; R01 HL080107-01A1/HL/NHLBI NIH HHS; R01HL080107/HL/NHLBI NIH HHS; T32 HL007937-01/HL/NHLBI NIH HHS; T32HL007937/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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