Comparative Assessment of Procedure Cost and Outcomes Between Guidewire and Crossing Device Strategies to Cross Peripheral Artery Chronic Total Occlusions

被引：24

作者：

Banerjee, Subhash ^{[1
,2
]}

Jeon-Slaughter, Haekyung ^{[1
,2
]}

Tsai, Shirling ^{[1
,2
]}

Mohammad, Atif ^{[1
]}

Foteh, Mazin ^{[3
]}

Abu-Fadel, Mazen ^{[4
]}

Gigliotti, Osvaldo S. ^{[5
]}

Cawich, Ian ^{[6
]}

Rodriguez, Gerardo ^{[6
]}

Kumbhani, Dharam ^{[1
]}

Addo, Tayo ^{[1
]}

Luna, Michael ^{[1
]}

Das, Tony S. ^{[7
]}

Prasad, Anand ^{[8
]}

Armstrong, Ehrin J. ^{[9
]}

Shammas, Nicolas W. ^{[10
]}

Brilakis, Emmanouil S. ^{[1
,2
]}

机构：

[1] Univ Texas Southwestern Med Ctr Dallas, Dallas, TX 75390 USA

[2] VA North Texas Hlth Care Syst, 4500 S Lancaster Rd,111a, Dallas, TX 75216 USA

[3] Cardiothorac & Vasc Surg, Austin, TX USA

[4] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA

[5] Seton Med Ctr, Austin, TX USA

[6] Arkansas Heart Hosp, Little Rock, AR USA

[7] Walnut Hill Med Ctr, Dallas, TX USA

[8] Univ Texas San Antonio, San Antonio, TX USA

[9] Denver VA Med Ctr, Denver, CO USA

[10] Midwest Cardiovasc Res Fdn, Davenport, IA USA

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2016年 / 9卷 / 21期

基金：

美国国家卫生研究院;

关键词：

chronic total occlusion; cost-benefit analysis; peripheral artery disease; VASCULAR INTERVENTION; CARE;

D O I：

10.1016/j.jcin.2016.08.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES The aim of this study was to assess actual procedural costs and outcomes comparing wire-catheter and dedicated chronic total occlusion (CTO) device strategies to cross peripheral artery CTOs. BACKGROUND Peripheral artery CTO interventions are frequently performed, but there are limited data on actual procedural costs and outcomes comparing wire-catheter and dedicated CTO devices. METHODS The XLPAD (Excellence in Peripheral Artery Disease Intervention) registry (NCT01904851) was accessed to retrospectively compare cost and 30-day and 12-month outcomes of wire-catheter and crossing device strategies for treatment of infrainguinal peripheral artery CTO. RESULTS Of all 3,234 treated lesions, 42% (n = 1,362) were CTOs in 1,006 unique patients. Wire-catheter approaches were used in 82% of CTOs, whereas dedicated CTO devices were used in 18% (p < 0.0001). CTO crossing device use was associated with significantly higher technical success (74% vs. 65%; p < 0.0001) and mean procedure cost($7,800.09 vs. $4,973.24; p < 0.0001). Because 12-month repeat revascularization (11.3% vs. 17.2%; p = 0.02) and amputation rates (2.8% vs. 8.5%; p = 0.002) in the CTO crossing device arm were lower compared with the wire-catheter group, the net cost for an initial CTO crossing device strategy was $423.80 per procedure. CONCLUSIONS An initial wire-catheter approach to cross a peripheral artery CTO is most frequently adopted. The use of dedicated CTO crossing devices provides significantly higher technical success and lower reintervention and amputation rates, at a net cost of $423.80 per procedure at 12 months. (C) 2016 by the American College of Cardiology Foundation.

引用

页码：2243 / 2252

页数：10

共 12 条

[11] Novel devices and specialized techniques in recanalization of peripheral artery chronic total occlusions (CTOs) - A literature review [J].

Liang, Gang Zhu ;

Zhang, Fu Xian .

INTERNATIONAL JOURNAL OF CARDIOLOGY, 2013, 165 (03) :423-429

[12]

Morrison G C, 1992, Health Econ, V1, P233, DOI 10.1002/hec.4730010405

← 1 2 →