Endovascular AAA treatment: expensive prestige or economic alternative?
OBJECTIVE
To compare the costs of endovascular aneurysm treatment versus open surgery during the perioperative period.


METHODS
Retrospective analysis of a consecutive series of 44 patients undergoing infrarenal abdominal aneurysm repair from February 1995 to March 1996 at a university teaching hospital.


RESULTS
No endovascular procedure was converted to open repair. Operative time was shorter for endovascular treatment (207.6 min vs. 229.1 min, n.s.), as well as postoperative intensive care unit stay (ICU, 22.7 h vs. 55.0 h, p = 0.017) and the postoperative recovery period (5.6 days vs. 13.3 days, p < 0.001). Open surgery generated significantly more costs (25,374.07 ECU vs. 22,268.78 ECU, p < 0.001), despite evaluation and a more expensive endovascular procedure (10,699.48 ECU vs. 4032.01 ECU, p < 0.001). During the study, costs for open surgery exceeded the cost for endovascular treatment by 13.95%.


CONCLUSIONS
Endovascular aneurysm treatment is cost effective and less expensive than open surgery. The main reason for cost saving is faster patient recovery after surgery, associated with a shorter LOS in the patients treated with endovascular procedure.
Hölzenbein
J
J
Department of Vascular Surgery, Vienna General Hospital, Austria.
Kretschmer
G
G
Glanzl
R
R
Schön
A
A
Thurnher
S
S
Winkelbauer
F
F
Trubel
W
W
Minar
E
E
Ahmadi
A
A
Huk
I
I
Ingruber
H
H
Ehringer
H
H
Lammer
J
J
Polterauer
P
P
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000191:economics* / Q000628:therapy*; D001317:Austria; D003362:Cost-Benefit Analysis; D004724:Endoscopy / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000191:economics* / Q000706:statistics & numerical data