The costs and effects of contrast-enhanced magnetic resonance angiography and digital substraction angiography on quality of life in patients with peripheral arterial disease.
BACKGROUND
Contrast-enhanced magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) both have a high diagnostic performance in the imaging of peripheral arterial occlusive disease (PAOD). However, little is known about the effects of initial, preoperative imaging using MRA or DSA on quality of life (QoL) in relation to costs (cost-utility).


OBJECTIVE
To compare cost-utility of treatment strategies using either MRA or DSA as the principal imaging tool, related to QoL, in patients with PAOD.


METHODS
In a prospective subgroup analysis of patients randomized between MRA and DSA (n = 79) for preoperative imaging, QoL questionnaires (SF-36) were obtained at randomization and at 4-month follow-up. Cost-effectiveness from hospital perspective was subsequently compared between groups and the difference in gained or lost QoL per € spent assessed using bootstrap analysis.


RESULTS
No difference in quality of life was found. A treatment trajectory employing MRA as the principal imaging modality was almost 20% cheaper, leading to a better cost-utility ratio in favor of MRA.


CONCLUSIONS
A treatment plan for peripheral arterial occlusive disease employing MRA versus DSA as the principal imaging modality yields a better cost/QoL ratio for MRA.
Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Jan
J
Bosma
Lea M
LM
Dijksman
Kayan
K
Lam
Willem
W
Wisselink
Alexander D Montauban
AD
van Swijndregt
Anco
A
Vahl
D000368:Aged; D015901:Angiography, Digital Subtraction / Q000191:economics* / Q000379:methods*; D003287:Contrast Media; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000191:economics* / Q000379:methods*; D008297:Male; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires
D003287:Contrast Media
Cost-utility analysis; contrast-enhanced magnetic resonance angiography; costs; digital subtraction angiography; quality of life