Costs in follow-up of endovascularly repaired abdominal aortic aneurysms: Magnetic resonance imaging with MR angiography versus EUROSTAR protocols

• Published in: International angiology Vol. 22; no. 1; pp. 36 - 42
• Main Authors: ENGELLAU, L, ALBRECHTSSON, U, HÖJGARD, S, NORGREN, L, LARSSON, E-M
• Format: Journal Article
• Language: English
• Published: Torino Minerva Medica 01.03.2003; Edizioni Minerva Medica
• Subjects: Aged; Angiography, Digital Subtraction - economics; Aortic Aneurysm, Abdominal - economics; Aortic Aneurysm, Abdominal - therapy; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis; Cardiac and Cardiovascular Systems; Cardiology. Vascular system; Cardiovascular system; Clinical Medicine; Contrast Media - adverse effects; Cost-Benefit Analysis; Costs and Cost Analysis; Diseases of the aorta; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Kardiologi; Klinisk medicin; Magnetic Resonance Angiography - economics; Magnetic Resonance Imaging - economics; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Renal Insufficiency - chemically induced; Renal Insufficiency - epidemiology; Risk Factors; Stents; Time Factors; Tomography, X-Ray Computed - economics; Human; Costs; Angiography; Aneurysm; Cardiovascular disease; Endovascular route; Risk analysis; Nuclear magnetic resonance imaging; Aortic aneurysm, abdominal; Arterial disease; Vascular disease; Abdominal aorta; Magnetic resonance imaging; Kidney diseases, chemically induced; Risk factor; Medical imagery; Costs and cost analysis; Cost analysis; Aortic disease; Comparative study; Contrast media; Cost efficiency analysis; Tomography, emission computed
• ISSN: 0392-9590; 1827-1839; 1827-1839

Endovascular repair of abdominal aortic aneurysms (AAA) necessitates a long-term follow-up. These patients are often old and renal insufficiency is not unusual. Cost-effectiveness needs to be addressed in evaluating methods of follow-up. The aim of this study was to compare costs of 5 years follow-up with magnetic resonance imaging with contrast enhanced three-dimensional magnetic resonance angiography (MRI/MRA) with follow-up using CT with DSA, or CTA. We also assessed the impact of contrast media induced (CMI) nephropathy on follow-up costs. We have implemented Swedish costs of CT with DSA, and CTA on the reported follow-up examinations from the EUROSTAR progress report 2000. The costs of follow-up with CT with DSA, or CTA were compared to a follow-up protocol with MRI/MRA. A cost analysis including a risk analysis of CMI nephropathy was made between MRI/MRA and CT with DSA, or CTA. Excluding the risk of CMI nephropathy, the 5 years follow-up cost in Euro ( ) with MRI/MRA ( 5715) is substantially higher than CT with DSA ( 3 095) or CTA ( 3573). The cost analysis favours MRI/MRA if the risk of CMI nephropathy from CT with DSA, or CTA is more than 5%. MRI/MRA can be cost-effective for follow-up of endovascularly repaired AAA depending on the risk of CMI nephropathy for CT with DSA, and CTA. MRI/MRA should be the method of choice for patients with pre-existing renal insufficiency.