Featured Research

from universities, journals, and other organizations

Carotid artery stenting shown to be cost-effective alternative to endarterectomy

Date:
March 3, 2011
Source:
Wiley-Blackwell
Summary:
Researchers determined that carotid artery stenting (CAS) with embolic protection is an economically attractive alternative to endarterectomy (END) for patients at increased surgical risk. This study is among the first to evaluate the long-term cost-effectiveness of CAS versus END in stroke and heart attack prevention.

Researchers determined that carotid artery stenting (CAS) with embolic protection is an economically attractive alternative to endarterectomy (END) for patients at increased surgical risk. The study, based on data from the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial, found that initial procedural cost was higher with CAS, but post-procedure hospital stay was shorter which significantly offset associated costs compared to END. Details of the study -- the first to evaluate the long-term cost-effectiveness of CAS versus END in stroke and heart attack prevention -- are published in the March issue of Catheterization and Cardiovascular Interventions, a peer-reviewed journal of The Society for Cardiovascular Angiography and Interventions (SCAI).

According to the Centers for Disease Control and Prevention (CDC), stroke is the third leading cause of death and the leading cause of serious long-term disability in the U.S. The CDC estimates that stroke cost the U.S. roughly $74 billion in healthcare services, medications, and lost productivity in 2010. Prior studies established carotid END as the standard of care for prevention of stroke in patients with carotid artery stenosis. However, the Food and Drug Administration (FDA) Circulatory System Devices Advisory Panel recently recommended expanding availability of CAS to patients with carotid artery disease at standard risk for surgical complications. The FDA recommendation and subsequent practice guidelines sponsored by 14 organizations, including SCAI, underscore the safety and efficacy of CAS as an option for patients needing revascularization.

In the current study, David Cohen, MD, and colleagues from St. Luke's Mid America Heart and Vascular Institute in Kansas City, Mo., evaluated the cost-effectiveness of CAS versus END using SAPPHIRE trial data. The SAPPHIRE trial included 310 patients with accepted indication for END but at high risk for complication who were then randomized and underwent CAS (n=159) or END (n=151). Researchers prospectively assessed clinical outcomes, resource use, costs and quality of life for all participants over a one-year period following the procedures.

"Our findings show that CAS with embolic protection offers a cost-effective alternative treatment option for patients with carotid artery atherosclerosis who are at high risk of adverse events with END," noted Dr. Cohen. Study results showed initial procedural costs were significantly higher for stenting ($7,000) than for END ($3,000). However, post-procedure hospital stay was one day shorter for CAS which reduced associated costs, resulting in initial costs for stenting being only $559 per patient higher than for END. Follow-up costs after discharge and total one-year costs did not differ between the two procedures.

Researchers also found after the first year, the rates of death, heart attack, major stroke and repeat carotid revascularization were lower with CAS compared with END (7% vs. 13%; 3% vs. 8%; 0.6% vs. 4%; 0.6% vs. 4%). Follow-up medical costs were $810 higher for stenting. "CAS appears to be a highly cost-effective option for high surgical risk patients," concluded Dr. Cohen. "Results should not be generalized to patients at low surgical risk, however. Further studies are needed to assess efficacy and cost-effectiveness of CAS in this patient population."


Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.


Journal Reference:

  1. Elizabeth M. Mahoney, Dan Greenberg, Tara A. Lavelle, Amy Natarajan, Ronna Berezin, K. Jack Ishak, Jamie J. Caro, Jay S. Yadav, William A. Gray, Mark H. Wholey, David J. Cohen. Costs and cost-effectiveness of carotid stenting versus endarterectomy for patients at increased surgical risk: Results from the SAPPHIRE trial. Catheterization and Cardiovascular Interventions, 2011; 77 (4): 463 DOI: 10.1002/ccd.22869

Cite This Page:

Wiley-Blackwell. "Carotid artery stenting shown to be cost-effective alternative to endarterectomy." ScienceDaily. ScienceDaily, 3 March 2011. <www.sciencedaily.com/releases/2011/03/110303111621.htm>.
Wiley-Blackwell. (2011, March 3). Carotid artery stenting shown to be cost-effective alternative to endarterectomy. ScienceDaily. Retrieved August 27, 2014 from www.sciencedaily.com/releases/2011/03/110303111621.htm
Wiley-Blackwell. "Carotid artery stenting shown to be cost-effective alternative to endarterectomy." ScienceDaily. www.sciencedaily.com/releases/2011/03/110303111621.htm (accessed August 27, 2014).

Share This




More Health & Medicine News

Wednesday, August 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Predicting Heart Transplant Rejection With a Blood Test

Predicting Heart Transplant Rejection With a Blood Test

Ivanhoe (Aug. 27, 2014) Now a new approach to rejection of donor organs could change the way doctors predict transplant rejection…without expensive, invasive procedures. Video provided by Ivanhoe
Powered by NewsLook.com
Better Braces That Vibrate

Better Braces That Vibrate

Ivanhoe (Aug. 27, 2014) The length of time you have to keep your braces on could be cut in half thanks to a new device that speeds up the process. Video provided by Ivanhoe
Powered by NewsLook.com
Smartphone App Tracks Your Heart Rate

Smartphone App Tracks Your Heart Rate

Ivanhoe (Aug. 27, 2014) A new app that can track your heart rate 24/7 is available for download in your app store and its convenience could save your life. Video provided by Ivanhoe
Powered by NewsLook.com
Stroke in Young Adults

Stroke in Young Adults

Ivanhoe (Aug. 27, 2014) A stroke can happen at any time and affect anyone regardless of age. This mother chose to give her son independence and continue to live a normal life after he had a stroke at 18 years old. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins