title: Cost-effectiveness of the radial versus femoral artery approach to diagnostic cardiac catheterization.
abstract: 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.
authors: Cardiology Section, Salem VA Medical Center, Salem, VA 24153, USA.
authors: Oleg
authors: O
authors: Roussanov
authors: S Jeanne
authors: SJ
authors: Wilson
authors: Katherine
authors: K
authors: Henley
authors: Greta
authors: G
authors: Estacio
authors: Judith
authors: J
authors: Hill
authors: Brenda
authors: B
authors: Dogan
authors: William F
authors: WF
authors: Henley
authors: Nabil
authors: N
authors: Jarmukli
mesh_terms: 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