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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >A cost-effectiveness analysis of carotid artery stenting compared with endarterectomy.
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A cost-effectiveness analysis of carotid artery stenting compared with endarterectomy.

机译：颈动脉支架置入术与动脉内膜切除术相比的成本效益分析。

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摘要

Endarterectomy and angioplasty with stenting have emerged as 2 alternative treatments for carotid artery stenosis. This study's objective was to determine the cost-effectiveness of carotid artery stenting (CAS) compared with carotid endarterectomy (CEA) in symptomatic subjects who are suitable for either intervention. A Markov analysis of these 2 revascularization procedures was conducted using direct Medicare costs (2007 USDollars ) and characteristics of a symptomatic 70-year-old cohort over a lifetime. In the base case analysis, CAS produced 8.97 quality-adjusted life-years, compared with 9.64 quality-adjusted life-years for CEA. The incremental cost of stenting was Dollars 17,700, and thus CAS was dominated by CEA. Sensitivity analyses show that the long-term probabilities of major stroke or mortality influenced the results. In the base case analysis, CEA for patients with symptomatic stenosis has a greater benefit than CAS, with lower direct costs. With 59% probability, CEA will be the optimal intervention when all of the model assumptions are varied simultaneously.
机译：动脉内膜切除术和带支架的血管成形术已成为颈动脉狭窄的2种替代治疗方法。这项研究的目的是确定适合于任何一种干预措施的有症状受试者的颈动脉支架置入术（CAS）与颈动脉内膜切除术（CEA）相比的成本效益。使用直接医疗保险费用（2007 USDollars）和一生中有症状的70岁队列的特征对这2个血运重建程序进行了马尔可夫分析。在基本案例分析中，CAS产生了8.97个质量调整生命年，而CEA则为9.64个质量调整生命年。支架的增支成本为17,700美元，因此CAS由CEA主导。敏感性分析表明，重大卒中或死亡的长期可能性影响结果。在基础病例分析中，对于有症状性狭窄的患者，CEA比CAS有更大的益处，直接费用更低。当所有模型假设同时变化时，CEA将以59％的概率成为最佳干预措施。

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