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DIRECT PROCEDURE COST AND 30-DAY OUTCOMES OF DRUG-COATED BALLOON USE IN FEMOROPOPLITEAL INTERVENTION: INSIGHTS FROM THE XLPAD REGISTRY
2253 JACC April 5, 2016 Volume 67, Issue 13
Vascular Medicine DIRECT PROCEDURE COST AND 30-DAY OUTCOMES OF DRUG-COATED BALLOON USE IN FEMOROPOPLITEAL INTERVENTION: INSIGHTS FROM THE XLPAD REGISTRY Moderated Poster Contributions Vascular Medicine Moderated Poster Theater, Poster Area, South Hall A1 Sunday, April 03, 2016, 1:15 p.m.-1:25 p.m. Session Title: Lower Extremity Peripheral Artery Disease: Endovascular Treatments and Outcomes Abstract Category: 43. Vascular Medicine: Endovascular Therapy Presentation Number: 1209M-07 Authors: Haekyung Jeon-Slaughter, Atif Mohammad, Donald Haagan, Shirling Tsai, Emmanouil Brilakis, Subhash Banerjee, University of Texas Southwestern Medical Center, Dallas, TX, USA, VA North Texas Health Care System, Dallas, TX, USA Background: Introduction of drug-coated balloons (DCB) has led to its use in combination with other non-stent strategies during femoropopliteal (FP) artery interventions.
Methods: We analyzed FP interventions from the XLPAD registry from October 2014 to October 2015 involving DCB for direct procedural costs and 30-day MALE (major adverse limb events): death, myocardial infarction, stroke, major bleeding or need for target vessel endovascular/surgical revascularization. To estimate direct procedure costs we used actual micro-costs of devices and assistive equipment; General Linear Method to test group differences, F-statistics for overall difference and t-statistics with Tukey-Kramer adjusted p-values for post-hoc comparisons. Results: Of 203 procedures, DCB was used in 38 (32%) of non-stent (n=120) FP procedures: DCB alone=20, DCB + atherectomy=18, atherectomy alone=63 and conventional angioplasty=19. In comparing DCB to DCB + atherectomy and atherectomy alone, there were no significant differences in baseline clinical and lesion characteristics; no significant difference in 30-day MALE (Figure 1a), however significantly lower median direct procedure cost: $14,617, $18,612 and $18,376, respectively (Figure 1b).
Conclusions: DCB is used in over a third of non-stent FP interventions, frequently combined with atherectomy, with overall lower direct procedural cost compared with atherectomy or atherectomy + DCB and similar 30-day clinical outcomes. Longer-term data are awaited.
Vascular Medicine DIRECT PROCEDURE COST AND 30-DAY OUTCOMES OF DRUG-COATED BALLOON USE IN FEMOROPOPLITEAL INTERVENTION: INSIGHTS FROM THE XLPAD REGISTRY Moderated Poster Contributions Vascular Medicine Moderated Poster Theater, Poster Area, South Hall A1 Sunday, April 03, 2016, 1:15 p.m.-1:25 p.m. Session Title: Lower Extremity Peripheral Artery Disease: Endovascular Treatments and Outcomes Abstract Category: 43. Vascular Medicine: Endovascular Therapy Presentation Number: 1209M-07 Authors: Haekyung Jeon-Slaughter, Atif Mohammad, Donald Haagan, Shirling Tsai, Emmanouil Brilakis, Subhash Banerjee, University of Texas Southwestern Medical Center, Dallas, TX, USA, VA North Texas Health Care System, Dallas, TX, USA Background: Introduction of drug-coated balloons (DCB) has led to its use in combination with other non-stent strategies during femoropopliteal (FP) artery interventions.
Methods: We analyzed FP interventions from the XLPAD registry from October 2014 to October 2015 involving DCB for direct procedural costs and 30-day MALE (major adverse limb events): death, myocardial infarction, stroke, major bleeding or need for target vessel endovascular/surgical revascularization. To estimate direct procedure costs we used actual micro-costs of devices and assistive equipment; General Linear Method to test group differences, F-statistics for overall difference and t-statistics with Tukey-Kramer adjusted p-values for post-hoc comparisons. Results: Of 203 procedures, DCB was used in 38 (32%) of non-stent (n=120) FP procedures: DCB alone=20, DCB + atherectomy=18, atherectomy alone=63 and conventional angioplasty=19. In comparing DCB to DCB + atherectomy and atherectomy alone, there were no significant differences in baseline clinical and lesion characteristics; no significant difference in 30-day MALE (Figure 1a), however significantly lower median direct procedure cost: $14,617, $18,612 and $18,376, respectively (Figure 1b).
Conclusions: DCB is used in over a third of non-stent FP interventions, frequently combined with atherectomy, with overall lower direct procedural cost compared with atherectomy or atherectomy + DCB and similar 30-day clinical outcomes. Longer-term data are awaited.