Cost-effectiveness of treating peripheral arterial disease and critical limb ischemia

Abstract

Introduction: Peripheral arterial disease of the lower limbs is characterized by high treatment costs and inten-sive resource use. Cost-effectiveness analyses are important for comparing treatments for patients with periph-eral arterial disease characterized by critical limb ischemia. Objective: The objective of this study was to com-pare the cost-effectiveness of conservative, endovascular, and surgical treatments in patients with critical limb ischemia. Methods: Data were analyzed from patients with critical ischemia treated between January 2020 and December 2021. Patients were treated conservatively, endovascularly, or surgically. Data regarding hospital stay duration and treatment costs were analyzed. Results: 220 patients were treated—14 conservatively, 158 via endovascular means, 34 via revascularization surgery, and 14 initially via endovascular attempt followed by surgical treatment in the same hospitalization. The cost per limb preserved for endovascular treatment was USD 3813, for surgical treatment was USD 5939, and for endovascular+surgical treatment was USD 15779 (p<0.01). The incremental cost-effectiveness ratio of surgical treatment compared to endovascular was USD 2291, and for endovascular+surgical compared to endovascular, it was USD -1001. Conclusion: Performing surgeries after failed angioplasties leads to increased costs without corresponding improvements in outcomes.