Endovascular and conventional treatment of thoracic aortic aneurysms: a comparison of costs.
BACKGROUND
The purpose of this study is to compare costs of conventional surgical therapy with costs of endovascular stent-graft placement in patients with thoracic aortic aneurysms.


METHODS
Fifteen patients undergoing either conventional surgical therapy or endovascular stent-graft placement of thoracic aortic aneurysms were analyzed. A catalog of costs was then created for both procedures and this catalog was applied individually to each patient.


RESULTS
Total costs of the service provision of endovascular stent-graft placement including anesthesia were 38.220.98 euros considering 1.7 stent-grafts per patient and including 5900.00 euros (Euros) for days of care. In conventional surgical therapy, adding the costs of the service provision of left heart catheterization, conventional surgical therapy including anesthesia, as well as intraoperative echocardiography a sum of 19.534.12 euros was calculated. Days of care accounted for 31.230.00 euros and total costs of 50.764.12 euros were calculated. The difference between total costs of the two procedures was 12.543.14 euros.


CONCLUSIONS
Costs of endovascular stent-graft placement in patients with thoracic aortic aneurysms compare favorably with conventional surgical therapy, revealing a cost benefit of 24.7%. Higher procedural costs are outweighed by a lower number of days of care. Nevertheless, aneurysm-related secondary endovascular or surgical procedures may balance the benefit of endovascular therapy. Which strategy to choose, conventional or endovascular, should remain to be based on age, comorbidity, and technical feasibility.
Schuster
Ingrid
I
Eastern Slovakian Institute of Cardiovascular Diseases, Kosice, Slovakia.
Dorfmeister
Marion
M
Scheuter-Mlaker
Sandra
S
Gottardi
Roman
R
Hoebartner
Michael
M
Roedler
Suzanne
S
Dziodzio
Tomasz
T
Juraszek
Andrzej
A
Loewe
Christian
C
Funovics
Martin
M
Holfeld
Johannes
J
Dumfarth
Julia
J
Zimpfer
Daniel
D
Schoder
Maria
M
Lammer
Johannes
J
Grimm
Michael
M
Czerny
Martin
M
D017545:Aortic Aneurysm, Thoracic / Q000191:economics* / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000191:economics*; D003365:Costs and Cost Analysis; D006801:Humans; D015607:Stents / Q000191:economics*; D014656:Vascular Surgical Procedures / Q000191:economics / Q000379:methods