title: Embolization of the internal iliac artery: cost-effectiveness of two different techniques.
abstract: The purpose of this study was to compare the cost-effectiveness of coils versus the Amplatzer Vascular Plug (AVP) for occlusion of the internal iliac artery (IAA). Between 2002 and January 2006, 13 patients (mean age 73 +/- 13 years) were referred for stent-grafting of abdominal aortic aneurysm (n = 6); type I distal endoleak (n = 3), isolated iliac aneurysm (n = 3), or rupture of a common iliac aneurysm (n = 1). In all patients, extension of the stent-graft was needed because the distal neck was absent. Two different techniques were used to occlude the IIA: AVP in seven patients (group A) and coil embolization in six patients (group C). Immediate results and direct material costs were assessed retrospectively. Immediate success was achieved in all patients, and simultaneous stent-grafting was successfully performed in two of six patients in group C versus five of seven patients in group A. In all group A patients, a single AVP was sufficient to achieve occlusion of the IIA, accounting for a mean cost of 485 euros, whereas in group C patients, an average of 7 +/- 3 coils were used, accounting for a mean cost of 1,745 euros. Mean average cost savings using the AVP was 1,239 euros. When IIA occlusion is needed, the AVP allows a single-step procedure at significant cost savings.
authors.affiliation: Cardiovascular Radiology Department, Georges Pompidou European Hospital, Université Paris 5 René Desxcartes, 20 rue Leblanc, 75908 Paris Cedex 15, France. olivier.pellerin@egp.aphp.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Pellerin
authors.forename: Thibaud
authors.initials: T
authors.lastname: Caruba
authors.forename: Yanis
authors.initials: Y
authors.lastname: Kandounakis
authors.forename: Luigi
authors.initials: L
authors.lastname: Novelli
authors.forename: Judith
authors.initials: J
authors.lastname: Pineau
authors.forename: Patrice
authors.initials: P
authors.lastname: Prognon
authors.forename: Marc
authors.initials: M
authors.lastname: Sapoval
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D016009:Chi-Square Distribution; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol