The Clinical and Fiscal Impact of Endovascular Repair of Abdominal Aortic Aneurysms


  • Daniel R. Watson
  • Thomas Tan
  • Lori Wiseman
  • Gary M. Ansel
  • Chip Botti
  • Barry George
  • Richard Snow



Purpose: This study analyzed cost, reimbursement, application, and outcome differences between endovascular (ER) and open repair (OR) of abdominal aortic aneurysms (AAA) in a community hospital.

Method: A total of 187 consecutive elective AAA repairs by both methods (69 ER, 118 OR) performed at a single center between July 2001 and March 2003 were analyzed. Average values in postoperative clinical and fiscal demographics were calculated for this period.

Results: The average length of stay was higher for OR than ER (9.38 days versus 1.94 days, P < .001). Significant reductions in operative time (4 hours versus 2.67 hours) and intensive care unit use (100% versus 4.05%) were seen in the ER population. Total hospital costs were slightly higher for OR than ER ($21,989 versus $19,668) despite a considerable difference in cost of the grafts (>$11,000 for ER versus <$500 for OR). However, hospital charges were much lower for ER than OR ($32,660 versus $48,877), and there was an average loss of $4986 on ER cases versus a profit of $2064 on OR procedures. Thirty-day mortality was not significantly improved in the ER population (1.45% versus 2.54%, P = .05).

Conclusions: Our data suggest that ER offers improvements in hospital convalescence and operating room times but no improvements in fiscal impact or overall morbidity/ mortality rates when similar preoperative medical risks exist.


Benzaquen BS, Eisenberg MJCR, Nguyen T, Brown KJ, Topol EJ. 1996. Correlates of in-hospital cost among patients undergoing abdominal aortic aneurysm repair. Am Heart J 136:696-702.nBlum U, Voshage G, Lammer J, et al. 1997. Endoluminal stent-grafts for infrarenal abdominal aortic aneurysms. N Engl J Med 336:13-20.nBreckwoldt WL, Mackey WC, O'Donnell TFJ. 1991. The economic implications of high-risk abdominal aortic aneurysms. J Vasc Surg 13:798-804.nClair DG, Gray B, O'Hara, et al. 2000. An evaluation of the costs tonhealth care institutions of endovascular aortic repair. J Vasc Surg 32: 148-52.nGold MR, Siegel JS, Russell LB, Weinstein MC, the Panel on Cost-Effectiveness in Health and Medicine. 1996. Cost-effectiveness in health and medicine. New York: Oxford University Press.nHolzenbein J, Kretschmer G, Glanzl R, et al. 1997. Endovascular AAA treatment: expensive prestige or economic alternative? Eur J Vasc Endovasc Surg 14:265-72.nJohnston KW. 1989. Multicenter prospective study of nonruptured abdominal aortic aneurysm; part II: variables predicting morbidity and mortality. J Vasc Surg 9:437-47.nMialhe C, Amicabile C, Becquemin JP. 1997. Endovascular treatment of infrarenal abdominal aneurysms by the Stentor system: preliminary results of 79 cases. J Vasc Surg 26:199-209.nZarins CK, White RA, Schwarten D, et al. 1999. AneuRx stent graft versus open surgical repair of abdominal aortic aneurysms: multicenter prospective clinical trial. J Vasc Surg 29:292-308.n



How to Cite

Watson, D. R., Tan, T., Wiseman, L., Ansel, G. M., Botti, C., George, B., & Snow, R. (2005). The Clinical and Fiscal Impact of Endovascular Repair of Abdominal Aortic Aneurysms. The Heart Surgery Forum, 7(5), E503-E507.




Most read articles by the same author(s)