Cost-effectiveness of the radial versus femoral artery approach to diagnostic cardiac catheterization.
BACKGROUND
The radial approach to cardiac catheterization is increasingly popular due to shorter procedural and recovery times and greater patient comfort.


METHODS
Comparative cost analysis between radial or femoral (with or without closure device) approaches were performed.


RESULTS
Radial (R), femoral (F), and femoral with a closure device (F +/- C) approaches were used in 70, 62 and 49 consecutive cases, respectively. Group R had higher access equipment cost (93.0 dollars +/- 9.5 vs. 40.5 dollars) in group F (p < 0.001), but lower catheter cost (19.7 dollars +/- 12.7 vs. 31.1 dollars +/- 9.3; p < 0.001) than Group F, and lower contrast cost (26.9 dollars +/- 17.0 vs. 42.9 dollars +/- 25.0) in Group F +/- C (p < 0.001). There was a lower postprocedure recovery cost (185.2 dollars +/- 52.7) in Group R compared to 337.5 dollars +/- 59.0 in Group F (p < 0.001) and 208 dollars +/- 70.4 in Group F +/- C (p < 0.001), with a median recovery time of 126.0 +/- 36.0 minutes in group R vs. 240.0 +/- 42.0 minutes, and 150.0 +/- 48.0 minutes in groups F and F +/- C, respectively (both p < 0.05). The total variable procedural cost, which includes approach-dependent equipment and recovery room stay, was significantly lower in the Radial group than in the Femoral group (369.5 dollars +/- 74.6 vs. 446.9 dollars +/- 60.2 and 553.4 dollars +/- 81.0; p < 0.001).


CONCLUSIONS
The radial artery approach to diagnostic cardiac catheterization is clearly more cost effective than the femoral approach, with or without the use of a femoral closure device.
Roussanov
Oleg
O
Cardiology Section, Salem VA Medical Center, Salem, VA 24153, USA.
Wilson
S Jeanne
SJ
Henley
Katherine
K
Estacio
Greta
G
Hill
Judith
J
Dogan
Brenda
B
Henley
William F
WF
Jarmukli
Nabil
N
D000368:Aged; D006328:Cardiac Catheterization / Q000191:economics* / Q000295:instrumentation / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D004864:Equipment and Supplies / Q000191:economics; D005263:Femoral Artery; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D017534:Radial Artery; D011997:Recovery Room / Q000191:economics; D013997:Time Factors