Should Endovascular Repair Be Reimbursed for Low Risk Abdominal Aortic Aneurysm Patients? Evidence from Ontario, Canada
2011

Cost-Effectiveness of Endovascular vs. Open Surgical Repair for Abdominal Aortic Aneurysms

Sample size: 335 publication 10 minutes Evidence: moderate

Author Information

Author(s): Jean-Eric Tarride, Gord Blackhouse, Guy De Rose, James M. Bowen, Hamid Reza Nakhai-Pour, Daria O'Reilly, Feng Xie, Teresa Novick, Robert Hopkins, Ron Goeree

Primary Institution: St. Joseph's Healthcare Hamilton and McMaster University

Hypothesis

Is endovascular repair (EVAR) more cost-effective than open surgical repair (OSR) for low-risk abdominal aortic aneurysm patients?

Conclusion

EVAR is more expensive than open repair for low-risk patients despite similar clinical effectiveness.

Supporting Evidence

  • EVAR patients had a lower 30-day mortality rate compared to high-risk OSR patients.
  • One-year health-related quality of life was lower in EVAR patients compared to OSR patients.
  • EVAR was cost-effective compared to OSR in high-risk patients but not in low-risk patients.

Takeaway

This study looked at two ways to fix a big blood vessel problem and found that one method costs more for patients who are not at high risk, even though both methods work about the same.

Methodology

A 1-year prospective observational study comparing EVAR and OSR in high and low-risk patients.

Potential Biases

Potential selection bias due to nonrandomized design.

Limitations

The study was nonrandomized and conducted at a single center, which may limit generalizability.

Participant Demographics

Patients with AAA > 5.5 cm, including 140 treated with EVAR and 195 with OSR, with 143 low-risk and 52 high-risk patients.

Statistical Information

P-Value

p<0.01

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1155/2011/308685

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication