Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures

Authors

Joshua S. Catapano, Barrow Neurological InstituteFollow
Andrew F. Ducruet, Barrow Neurological InstituteFollow
Stefan W. Koester, Barrow Neurological InstituteFollow
Tyler S. Cole, Barrow Neurological InstituteFollow
Jacob F. Baranoski, Barrow Neurological InstituteFollow
Caleb Rutledge, Barrow Neurological InstituteFollow
Neil Majmundar, Rutgers University-Newark Campus
Visish M. Srinivasan, Barrow Neurological InstituteFollow
D. Andrew Wilkinson, Pennsylvania State University
Michael T. Lawton, Barrow Neurological InstituteFollow
Felipe C. Albuquerque, Barrow Neurological InstituteFollow

Document Type

Article

Abstract

Background Transradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions. Methods Elective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access. Results Of the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI -$4931 to -$97; p=0.04). Conclusion Neuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.

Publication Date

8-1-2021

Publication Title

Journal of NeuroInterventional Surgery

ISSN

17598478

E-ISSN

17598486

Volume

13

Issue

8

First Page

752

Last Page

754

PubMed ID

33106321

Digital Object Identifier (DOI)

10.1136/neurintsurg-2020-016728

Recommended Citation

Catapano, Joshua S.; Ducruet, Andrew F.; Koester, Stefan W.; Cole, Tyler S.; Baranoski, Jacob F.; Rutledge, Caleb; Majmundar, Neil; Srinivasan, Visish M.; Wilkinson, D. Andrew; Lawton, Michael T.; and Albuquerque, Felipe C., "Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures" (2021). Neurosurgery. 1396.
https://scholar.barrowneuro.org/neurosurgery/1396