Carotid endarterectomy is less expensive than transcarotid artery revascularization

作者：Valerie Collins, Lily S.F. Adler, Jennifer E. Geller, Charles Hamilton, Nadia K. Palte, Moira McGevna, Jennifer Delgado, Saum Rahimi, William E. Beckerman · 发表于：Journal of Vascular Surgery · 年份：2025 · DOI：10.1016/j.jvs.2025.03.192 · 被引用次数：5 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Peripheral Artery Disease Management、Intracranial Aneurysms: Treatment and Complications

OBJECTIVE: Transcarotid artery revascularization (TCAR) is safe and effective for treatment of carotid stenosis, with comparable short-term outcomes with carotid endarterectomy (CEA). Few peer-reviewed studies evaluated the comparative costs of these two procedures. The objective of this study was to compare the costs of these procedures at a single institution. METHODS: This was a retrospective analysis of patients receiving TCAR or CEA at a single tertiary care center from August 2018 to July 2023. Patient characteristics, demographics, and procedure cost data were extracted from the electronic medical record. Stay costs were calculated using estimates derived from literature and adjusted for inflation. A subset of patient charts from June 2022 to July 2023 were used to calculate a baseline procedure cost for the TCAR and CEA cohorts, with individual implant cost from each chart added to obtain estimated procedure cost. Patients with insufficient chart data or who were converted from TCAR to CEA were excluded from analysis. RESULTS: Of 187 patients, 51 received TCAR and 136 received CEA. Patients undergoing TCAR were significantly older (74 vs 70 years; P = .007) and more likely to have a history of prior ipsilateral carotid intervention (9.8% vs 0.7%; P = .003), contralateral carotid intervention (18% vs 13%; P = .003), or neck surgery (35% vs 18%; P = .01). Procedure length was shorter in the TCAR group (104 vs 130 minutes; P = .002). No differences were found between TCA...