Economic Burden between Carotid endarterectomy and carotid angioplasty assisted with stenting: Retrospective Pilot Study

초록

Purpose : Carotid artery artherosclerosis is one of stroke risk factors. Carotid endarterectomy(CEA) and carotid angioplasty assisted with stenting(CAS) have been known as effective treatments for this lesion. However, the difference in economic burden between two options remained still unclear in Korea. This study investigated the difference in economic burden between two groups Methods : A total of 40 patients were included in this study. All patients underwent either carotid angioplasty and stenting(CAS) or carotid endarterectomy(CEA) between 2010 and 2012 in Inha University hospital. We analyzed in-hospital cost(including pre-procedure, procedure and postprocedure), length of stay for economic loading. Results : Forty patients were finally enrolled. There was no significant difference in age, sex ratio and the frequency of hypertension between two groups. The CEA group(N=20) had more symptomatic (95% vs 65%; P<0.01) and hyperlipidemia (55% vs 25%;P=0.02) patients, compared to CAS group(N=20). The CAS group had the history of alcohol intake(25% versus 10%;P<0.01) and of peripheral artery occlusive disease (15% versus 5%;P<0.01), more frequently than CEA group. There was no difference in total in-hospital cost between CEA group than CAS group(9,238 vs 10,507. *1000 KW). After national insurance coverage, patients burden of CAS group was smaller than CEA group(CAS 4,878 vs CEA 5,619. *1000KW). Although there was no difference in total costs before procedure, CAS group had the larger economic burden during procedure day and smaller burden during post-procedure care, compared to CEA group. The length of stay was less in CAS group than CEA group(15±9 vs 35±37 day). There was no difference in procedure-related complication between two groups. Conclusions : Total economic burden was similar and the length of stay and the patient's burden were substantially less in CAS group than CEA group.