Cost effectiveness of radial access for diagnostic cardiac catheterization and coronary intervention

Robert Applegate, Matthew Sacrinty, Pascha Emmons Schafer, Justin Smith, Sanjay Gandhi, Michael Kutcher, Renato Santos, Adam Cecile, William Little

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives To evaluate the cost effectiveness of diagnostic cardiac catheterizations (CATH) and coronary interventions (PCI) performed using radial artery (RA) access compared to femoral artery (FA) access. Background CATH and PCI performed from the RA reduce access site complications compared to FA, but can increase procedure duration, and equipment and contrast use. Whether resulting increases in utilization costs are offset by reduced costs of complications is uncertain. Methods In all, 6,726 CATH and PCI (RA, 3,368; FA, 3,358) were performed from January 2009 to December 2011. Procedural costs and cost of access site complications were compared for propensity-matched CATH (RA and FA, 1,222) and PCI (RA and FA, 570) throughout a complete transition of the lab from a preferred FA to preferred RA strategy. Results Adjusted mean total costs were $10 more (95% confidence interval $613 less to $610 more) for RA-CATH versus FA-CATH and $732 less ($1,345 less to $156 less) for RA-PCI versus FA-PCI. The incremental cost per vascular or bleeding complication avoided with RA-CATH was $1,265, whereas RA was economically dominant with lower costs and fewer complications compared to FA for PCI and all procedures. Conclusions Radial access for CATH and PCI reduced access site complications and overall costs compared to FA procedures with similar baseline clinical and procedural characteristics, making it an economically advantageous strategy.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
Volume82
Issue number4
DOIs
StatePublished - Oct 1 2013
Externally publishedYes

Fingerprint

Radial Artery
Femoral Artery
Cardiac Catheterization
Cost-Benefit Analysis
Catheterization
Costs and Cost Analysis
Blood Vessels
Confidence Intervals
Hemorrhage
Equipment and Supplies

Keywords

  • cost effectiveness
  • femoral artery
  • radial artery
  • vascular complications

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Cost effectiveness of radial access for diagnostic cardiac catheterization and coronary intervention. / Applegate, Robert; Sacrinty, Matthew; Schafer, Pascha Emmons; Smith, Justin; Gandhi, Sanjay; Kutcher, Michael; Santos, Renato; Cecile, Adam; Little, William.

In: Catheterization and Cardiovascular Interventions, Vol. 82, No. 4, 01.10.2013.

Research output: Contribution to journalArticle

Applegate, Robert ; Sacrinty, Matthew ; Schafer, Pascha Emmons ; Smith, Justin ; Gandhi, Sanjay ; Kutcher, Michael ; Santos, Renato ; Cecile, Adam ; Little, William. / Cost effectiveness of radial access for diagnostic cardiac catheterization and coronary intervention. In: Catheterization and Cardiovascular Interventions. 2013 ; Vol. 82, No. 4.
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