Comparison of costs of new atherectomy devices and balloon angioplasty for coronary artery disease.
The in-hospital cost for 126 consecutive patients undergoing 1-vessel, single-lesion coronary atherectomy (atherectomy group) beginning January 1, 1991, was reviewed (65 directional, 44 rotational, and 17 extractional atherectomies), and compared with the cost for 126 consecutive patients matched by sex and age who underwent 1-vessel, single-lesion standard balloon coronary angioplasty (angioplasty group). The in-hospital cost for each patient was determined using charges divided by a correction factor for each hospital department involved. Six different cost fields were created. The overall cost/charge ratio was 0.72. Angiographic and clinical success was 91% and 90% in the angioplasty group and 93% and 90% in the atherectomy group, respectively. Patients who underwent angioplasty required 1.3 +/- 0.6 devices/procedure, as compared with those who underwent atherectomy (2.4 +/- 1 devices/procedure) (p < 0.0001). The mean cost of angioplasty was $7,301 +/- $4,637 and of atherectomy devices $9,345 +/- $8,856 (28% increase). The difference was principally related to an increase in cost of supplies: angioplasty $2,028 +/- $1,196 versus atherectomy $3,632 +/- $1,525 (79% increase). There were no significant differences in hospitalization cost, procedure-room cost, and pharmacy and laboratory costs. Thus, higher risk morphologic lesions can be approached with new atherectomy devices with clinical and complication rates similar to coronary angioplasty. However, these results were obtained at a 28% increase in cost.
Department of Cardiology, Cleveland Clinic Foundation, OH 44195-5066.
L A
LA
Guzman
C
C
Simpfendorfer
J
J
Fix
I
I
Franco
P L
PL
Whitlow
D015906:Angioplasty, Balloon, Coronary / Q000191:economics*; D017225:Atherectomy, Coronary / Q000191:economics* / Q000379:methods; D003327:Coronary Disease / Q000191:economics / Q000601:surgery / Q000628:therapy*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006770:Hospitals, Group Practice / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009820:Ohio; D016896:Treatment Outcome