Journal of Vascular Surgery
Volume 48, Issue 4 , Pages 779-787 , October 2008

Cost-effectiveness analysis of elective endovascular repair compared with open surgical repair of abdominal aortic aneurysms for patients at a high surgical risk: A 1-year patient-level analysis conducted in Ontario, Canada

  • Jean-Eric Tarride, PhD

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • Corresponding Author InformationReprint requests: Jean-Eric Tarride, PhD, Programs for Assessment of Technology in Health (PATH) Research Institute, 25 Main St W, Ste 2000, Hamilton, ON L8P 1H1, Canada
    • ,
  • Gord Blackhouse, BComm, MBA, MSc

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Guy De Rose, BSc, MD

      Affiliations

    • Division of Vascular Surgery, Department of Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
    • Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, University of Western Ontario, London, Ontario, Canada
    • ,
  • Teresa Novick, RN, BA

      Affiliations

    • Division of Vascular Surgery, Department of Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
    • ,
  • James M. Bowen, BScPhm, MSc

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Robert Hopkins, BA, BSc, MA

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Daria O'Reilly, PhD

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
    • ,
  • Ron Goeree, MA

      Affiliations

    • Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

Received 6 February 2008 ,Accepted 19 May 2008.

References 

  1. Anderson PL, Arons RR, Moskowitz AJ, Gelijns A, Magnell C, Faries PL, et al. A statewide experience with endovascular abdominal aortic aneurysm repair: rapid diffusion with excellent early results. J Vasc Surg. 2004;39:10–19
  2. McAuley LM, Fisher A, Hill AB, Joyce J. Endovascular repair compared with open surgical repair of abdominal aortic aneurysm: Canadian practice and a systematic review (Technology Report 33). Ottawa, ON, Canada: Canadian Coordinating Office for Health Technology Assessment; 2002;
  3. Lindsay TF. Canadian Society for Vascular Surgery consensus statement on endovascular aneurysm repair. CMAJ. 2005;172:867–868
  4. Jonk YC, Kane RL, Lederle FA, Macdonald R, Cutting AH, Wilt TJ. Cost-effectiveness of abdominal aortic aneurysm repair: a systematic review. Int J Technol Assess Health Care. 2007;23:205–215
  5. Epstein DM, Sculpher MJ, Manca A, Michaels J, Thompson SG, Brown LC, et al. Modelling the long-term cost-effectiveness of endovascular or open repair for abdominal aortic aneurysm. Br J Surg. 2008;95:183–190
  6. Prinssen M, Buskens E, de Jong SE, Buth J, Mackaay AJ, van Sambeek MR, et al. Cost-effectiveness of conventional and endovascular repair of abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg. 2007;46:883–890
  7. Hynes N, Sultan S. A prospective clinical, economic, and quality-of-life analysis comparing endovascular aneurysm repair (EVAR), open repair, and best medical treatment in high-risk patients with abdominal aortic aneurysms suitable for EVAR: the Irish patient trial. J Endovasc Ther. 2007;14:763–776
  8. Ramage D, Lovell M, DeRose G, Harris KA, Kribs S. Establishing an endovascular abdominal aortic program–decisions, decisions, decisions: The London Health Sciences Centre experience. J Vasc Nurs. 2001;19:10–13
  9. Faizer R, DeRose G, Lawlor DK, Harris KA, Forbes TL. Objective scoring systems of medical risk: a clinical tool for selecting patients for open or endovascular abdominal aortic aneurysm repair. J Vasc Surg. 2007;45:1102–1108
  10. Chaikof EL, Fillinger MF, Matsumura JS, Rutherford RB, White GH, Blankensteijn JD, et al. Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1061–1066
  11. Brewster DC, Cronenwett JL, Hallett JW, Johnston KW, Krupski WC, Matsumura JS. Guidelines for the treatment of abdominal aortic aneurysms (Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery). J Vasc Surg. 2003;37:1106–1117
  12. Hollier LH, Taylor LM, Ochsner J. Recommended indications for operative treatment of abdominal aortic aneurysms (Report of a subcommittee of the Joint Council of the Society for Vascular Surgery and the North American Chapter of the International Society for Cardiovascular Surgery). J Vasc Surg. 1992;15:1046–1056
  13. Statistics Canada. http://www.statcan.ca/2006;
  14. Laupacis A, Feeny D, Detsky AS, Tugwell PX. How attractive does a new technology have to be to warrant adoption and utilization? (Tentative guidelines for using clinical and economic evaluations). CMAJ. 1992;146:473–481
  15. Drury D, Michaels JA, Jones L, Ayiku L. Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm. Br J Surg. 2005;92:937–946
  16. Sicard GA, Zwolak RM, Sidawy AN, White RA, Siami FS. Endovascular abdominal aortic aneurysm repair: long-term outcome measures in patients at high-risk for open surgery. J Vasc Surg. 2006;44:229–236
  17. Nagpal AD, Forbes TL, Novick TV, Lovell MB, Kribs SW, Lawlor DK, et al. Midterm results of endovascular infrarenal abdominal aortic aneurysm repair in high-risk patients. Vasc Endovascular Surg. 2007;41:301–309
  18. Soulez G, Therasse E, Monfared AA, Blair JF, Choiniere M, Stephane E, et al. Pain and quality of life assessment after endovascular versus open repair of abdominal aortic aneurysms in patients at low risk. J Vasc Interv Radiol. 2005;16:1093–1100
  19. Brox AC, Filion KB, Zhang X, Pilote L, Obrand D, Haider S, et al. In-hospital cost of abdominal aortic aneurysm repair in Canada and the United States. Arch Intern Med. 2003;163:2500–2504
  20. Forbes TL, DeRose G, Kribs S, Harris KA. A cost-effectiveness analysis of standard versus endovascular abdominal aortic aneurysm repair. Can J Surg. 2002;45:420–424

 Competition of interest: none.

 This project was funded by the Ontario Ministry of Health & Long-term Care (Contract No. 06129) to address the 2002 recommendations of the Ontario Health Technology Advisory Committee regarding EVAR. The final study results were presented to the Ontario Health Technology Advisory Committee on December 15, 2006. Daria O'Reilly and Jean-Eric Tarride each hold a 2007 Career Scientist Award, Ontario Ministry of Health and Long-Term Care.

PII: S0741-5214(08)00867-7

doi: 10.1016/j.jvs.2008.05.064

Journal of Vascular Surgery
Volume 48, Issue 4 , Pages 779-787 , October 2008

Article Tools

* Image Usage & Resolution