title: Endovascular and conventional treatment of thoracic aortic aneurysms: a comparison of costs.
abstract: 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.
authors.affiliation: Eastern Slovakian Institute of Cardiovascular Diseases, Kosice, Slovakia.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Schuster
authors.forename: Marion
authors.initials: M
authors.lastname: Dorfmeister
authors.forename: Sandra
authors.initials: S
authors.lastname: Scheuter-Mlaker
authors.forename: Roman
authors.initials: R
authors.lastname: Gottardi
authors.forename: Michael
authors.initials: M
authors.lastname: Hoebartner
authors.forename: Suzanne
authors.initials: S
authors.lastname: Roedler
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dziodzio
authors.forename: Andrzej
authors.initials: A
authors.lastname: Juraszek
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
authors.forename: Martin
authors.initials: M
authors.lastname: Funovics
authors.forename: Johannes
authors.initials: J
authors.lastname: Holfeld
authors.forename: Julia
authors.initials: J
authors.lastname: Dumfarth
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Michael
authors.initials: M
authors.lastname: Grimm
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
mesh_terms: 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