Cost-effectiveness of carotid artery stent placement versus endarterectomy in patients with carotid artery stenosis

Journal of Neurosurgery
Asif A KhanAdnan I Qureshi

Abstract

The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) demonstrated that the risk of the primary composite outcome of stroke, myocardial infarction (MI), or death did not differ significantly in patients with an average surgical risk undergoing carotid artery stenting (CAS) and those undergoing carotid endarterectomy (CEA). However, the cost associated with CAS may limit its broad applicability. The authors' goal in this paper was to determine the cost-effectiveness of CAS with an embolic-protection device versus CEA in patients with moderate to severe carotid artery stenosis who are at average surgical risk. The probability of the primary outcome was obtained from the results of the CREST trial. The quality-adjusted life years (QALYs) associated with each treatment modality were estimated by adjusting for the incidence of each quality-adjusted outcome (QALY weights of ipsilateral stroke, MI, death, and postprocedure QALYs). The total cost associated with each intervention was derived from hospitalization cost and cost associated with primary outcomes including stroke, MI, and death in each group. Costs are expressed in US dollars accounting for inflation up to October 2010. Incremental cost-effectiveness ra...Continue Reading

References

Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Feb 1, 1997·Journal of Vascular Surgery·J L CronenwettD B Walsh
Jan 28, 2004·Neurosurgery·Adnan I QureshiUNKNOWN North American Trial of Unruptured and Ruptured Aneurysms Planning Committee
Mar 28, 2008·Current Neurology and Neuroscience Reports·Gustavo J Rodriguez, Adnan I Qureshi
Jul 25, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M P JanssenE Buskens
Dec 5, 2009·Vascular and Endovascular Surgery·Todd R VogelAlan M Graham
Apr 30, 2010·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Alberto MaudAdnan I Qureshi
May 28, 2010·The New England Journal of Medicine·Thomas G BrottUNKNOWN CREST Investigators
Feb 26, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Elizabeth M MahoneyDavid J Cohen

❮ Previous
Next ❯

Citations

Apr 24, 2014·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Melissa J DonovanW Charles Sternbergh
Jun 1, 2017·Journal of Vascular Surgery·Lorenzo RinaldoGiuseppe Lanzino
May 2, 2018·Neurosurgical Focus·Won Hyung A RyuJay Riva-Cambrin
Nov 28, 2012·Circulation·Donald E Cutlip, Duane S Pinto
Jul 18, 2014·Neurosurgery·Liang ChenLiangfu Zhou
Sep 23, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Zhe XueTianxiang Dong

❮ Previous
Next ❯

Software Mentioned

MATLAB
CREST

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.