Cost-benefit analysis of endovascular versus open abdominal aortic aneurysm treatment

Objective: To compare the costs and benefits of open versus endovascular re pair of abdominal aortic aneurysm (AAA). Methods: a consecutive series of 29 elective patients (open treatment, N = 20 and endovascular treatment, N = 9) were compared retrospectively. Results: operating time was significantly shorter for endovascular treatmen t (mean 90 vs. 125 min, p = 0,026). No endovascular procedure was converted to open surgery; one early endoleak was seen which sealed spontaneously. E ndovascular treatment resulted in a shorter ICU and hospital stay (0 days v s. 2 days, p.0,001 and 5 days vs. 11 days, p = 0,01 respectively). Mean tot al cost did not differ 361 938 BEF (9 048 Euro) vs. 382 995 BEF (9 575 Euro ), p = 0,46. Endovascular treatment generated significantly less hospitaliz ation costs (73 162 BEF or 1 829 Euro vs. 18 2740 BEF or 4 568 Euro, p = 0, 001) but required a more expensive implant (153 293 BEF or 3 832 Euro vs. 3 8 296 BEF or 957 Euro, p = 0,001). Mean total cost for the patient was sign ificantly higher in the endovascular treatment group (66 309 BEF or 1 658 E uro vs. 24969 BEF or 624 Euro, p = 0,003). Conclusion : our experience confirms the feasibility and safety of endovasc ular AAA treatment. It is associated with a shorter ICU and hospital stay a nd less morbidity. Overall cost for society does not differ significantly a s the benefit of lower hospitalization costs is undone by the high cost of the endovascular graft.