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