Cost-identification analysis of revascularization procedures on patients with peripheral arterial occlusive disease

Abstract

Total in-hospital costs per admission for peripheral revascularization procedures are highly variable and significantly increased by procedure-related complications, advanced age, female sex, management of critical ischemia, and presence of coronary artery disease.

Cost and Patency Rate Targets for the Development of Endovascular Devices to Treat Femoropopliteal Arterial Disease

“…Percutaneous transluminal balloon angioplasty is a low-risk and low-cost procedure, but it is associated with a fairly high restenosis rate (2)(3)(4)(5). Primary stent placement does not improve the patency rate of PTA performed for femoropopliteal arterial disease and is thus currently used only to salvage a failed balloon angioplasty procedure (6,7).…”

“…Primary stent placement does not improve the patency rate of PTA performed for femoropopliteal arterial disease and is thus currently used only to salvage a failed balloon angioplasty procedure (6,7). Bypass surgery, on the other hand, has higher long-term patency rates but is also associated with a higher procedural risk, higher cost, and longer convalescence period (4,5). In general, PTA is performed as primary treatment of short focal lesions of the femoropopliteal artery, whereas bypass surgery is the primary treatment in diffuse disease.…”

“…Therefore, we assumed that the data used in the 1995 model were still valid. Furthermore, there is evidence that the cost of femoropopliteal revascularization has not changed considerably during the past few years (5).…”

Is Thrombolysis of Lower Extremity Acute Arterial Occlusion Cost-Effective?

“…We assigned an average cost of $20,271 for patients undergoing a major reconstruction. This value was derived from a study by Jansen and colleagues [11] where the costs associated with 467 major bypass procedures, which included aortobifemoral, iliofemoral, femorofemoral, femoropopliteal, femoroinfrapopliteal, and popliteoinfrapopliteal bypasses, were evaluated. This cost is comparable to that reported by others for major lower extremity reconstructions [12,13].…”

“…A moderate open surgical procedure was defined as graft revision, endarterectomy, profundaplasty, exploratory vascular procedure, or a transmetatarsal amputation. Based upon data from Jansen et al [11], we assumed that the cost of endarterectomy ($12,596) would be representative of a moderate procedure. In the TOPAS trial, the number of moderate procedures performed was 98 in the thrombolysis group and 145 in the surgery group.…”