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P Narayan, A Wong, I Davies, A J Bryan, P Wilde, G J Murphy

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Does TEVAR provide a financial benefit for management of descending thoracic aortic pathologies?. P Narayan, A Wong, I Davies, A J Bryan, P Wilde, G J Murphy. Background Management of descending aortic pathology is a complex and challenging area

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Presentation Transcript
slide1

Does TEVAR provide a financial benefit for management of descending thoracic aortic pathologies?

P Narayan, A Wong, I Davies, A J Bryan, P Wilde, G J Murphy

slide2
Background

Management of descending aortic pathology is a complex and challenging area

Surgical management is indicated in specific situations

Endo-Vascular Surgical Repair [TEVAR] provides another important option

Aim

To assess early and mid term outcomes of TEVAR compared with surgical repair

To compare the financial implications of TEVAR and surgical management

methods
Methods
  • Retrospective study
  • Time period: April 1996- February 2009
  • 85 procedures

Surgical repair: 35

TEVAR: 49

  • Data accessed from computerised database –PATS System

and validated by case note reviews

  • Hospital costs calculated from NHS reference costs for staff time, consumables, transfusion and length of stay.
statistical analysis
Statistical Analysis
  • Data tabulated as N(%) for categorical data and median (inter-quartile range) for continuous data
  • Continuous variables analysed with Mann Whitney U test
  • Categorical variables analysed with Fisher’s exact test or Chi-square
  • Kaplan-Meier estimates were used to compare re- intervention and survival
mid term outcomes of tevar and surgery for diseases of the descending thoracic aorta
Mid-term Outcomes of TEVAR and Surgery for Diseases of the Descending Thoracic Aorta

Re-intervention

Mortality

Log Rank p=0.002

Log Rank p=0.901

TEVAR

TEVAR

Surgery

Surgery

conclusions
Conclusions
  • TEVAR is associated with superior short-term results
  • Mid term survival is similar to surgery
  • Re-intervention rate is significantly higher in TEVAR
  • Resource utilisation is similar in both groups for the primary procedure
  • Costs may prove to be higher in the TEVAR group with re-interventions
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