Coste del tratamiento del aneurisma de aorta abdominal: cirugía abierta frente a tratamiento endovascular

Objective: To compare costs of endovascular repair (EVAR) with open repair (OR) in abdominal aortic aneurysms. To determine the morbidity, mortality, and reintervention rates. Material and methods: A retrospective cohort study was conducted on patients with MA that were treated during 2008-2009 with EVAR and OR, in order to obtain the total cost of each treatment. The study variables were extracted from the analytical accounting unit of our hospital. Such data consist of the cost of prosthesis, OR time, anaesthesia, blood products, intensive care unit, and length of hospital stay. Imaging tests and monitoring of patients after reintervention were also included. Complications, mortality (perioperative and follow-up) and reoperation rates, were recorded. Statistical analysis was performed using contingency tables according to a Cox model and the Student t test. Results: A total of 74 cases were found in the 2 year period of the study, of whom 40 patients were treated with OR, and 34 with EVAR. The mean cost was 12,089.70 in OR and 19,682.30 for EVAR (P<.0001, 95% ci; 10,952.36-13,488.11), with the differences due to the cost of the endoprosthesis accounting for 65.7% of the total. Mortality during follow-up was 20% in OR (8 cases), and 31.3% (10) in EVAR (p=.273). The reoperation rate was 20% (8) in OR, compared to 20.6% (7) in EVAR (p=.950). Conclusions: The endovascular treatment of AAA in our hospital is more expensive compared to OR. Although the current competitive market environment could possible put both treatments on the same level in the future. (C) 2014 SEACV. Published by Elsevier Espana, S.L.U. All rights reserved.