News | January 21, 2008

Research Finds Treating PAD More Costly than CAD

January 22, 2008 � Blocked abdomen and leg arteries, known as peripheral arterial disease (PAD), is more costly to treat than coronary heart diseases (CAD), according to research being presented at the 20th annual International Symposium on Endovascular Therapy (ISET).

Both CAD and PAD are atherosclerotic cardiovascular diseases involving blocked arteries, and are treated with the same methods, including medication, minimally invasive (endovascular) techniques � such as balloon angioplasty and stenting � or surgery, depending on the location and severity of the disease.

Although the treatment strategies are the same, they tend to be more successful in the heart, potentially contributing to the cost difference. It costs about five percent more to treat a PAD patient than to treat a CAD patient, suggests the study.

�Patients with heart disease who get treated with a stent typically are doing just fine when seen six to 12 months later,� said Michael R. Jaff, D.O., principal investigator of the study and director of the Massachusetts General Hospital Vascular Center, Boston. �Patients with PAD have to be seen frequently and many of the treatments don�t last as long, so it costs more to care for these patients.� One of the reasons is that blockages in the heart arteries are short and near the origin of arteries, whereas in the peripheral arteries, the blockages tend to be longer and more diffuse (spread out).

The study involved looking at a random sample of 5 percent of patients (2.8 million) in the Medicare system from 1999-2005, and performing a cost analysis on 45,814 patients who received PAD treatment during that time period. On average, PAD patients incurred $50,110 in costs for the period of initial treatment and the year following, while treated CAD patients incurred $47,515 in costs for a similar time period,1 according to Medicare Standard Analytic Files.

Further, PAD is on the rise, affecting 8.2 percent of people in the study in 1999 and 9.5 percent of people by 2005, most of whom were 65 or older. PAD was more common among those 75 and older, increasing from 12.7 percent to 14.5 percent in that population during the six-year span.

Regarding PAD treatment, the study also found:
- Patients with diabetes mellitus cost more to treat than nondiabetic patients. That�s likely because diabetic patients typically have more extensive and severe PAD due to the effects of the diabetes. Results from other studies estimate that about one-third of people with diabetes who are 50 or older have PAD, according to the American Diabetes Association.
- Minimally invasive endovascular treatment tended to be more successful than surgery in PAD patients, possibly due to the prolonged recovery time for surgical patients and the potential for repeated treatments. Patients with less extensive disease typically can benefit from endovascular techniques, while patients with more serious disease often are treated with surgery.

Rather than treating the blockages through the larger incisions required by surgery, endovascular treatments involve threading a tiny tube, called a catheter, through a nick in the groin and advancing the catheter through an artery to the site of the blockage, whether in the abdomen, leg or heart arteries. A number of treatments then can be employed, including advancing a tiny balloon to the site and inflating it to open up the clogged artery, leaving behind a stent, or small metal cage, to prop open the artery, or using other techniques, such as lasers, to remove the blockage.

�These data suggest that future trials of PAD therapy should take into account the high cost of treating these patients, particularly those with diabetes mellitus,� said Dr. Jaff. �When therapies work equally well, but there are cost advantages of one over the other, the less expensive therapy should be tried first.�

For more information: www.ISET.org.

Related Content

News | Peripheral Artery Disease (PAD)| December 29, 2017
December 29, 2017 — iVascular announced the release of the new Oceanus 14 Pro percutaneous transluminal angioplasty (
Lesion Preparation Via Atherectomy Enhances Paclitaxel Distribution in Calcified Peripheral Arteries
News | Peripheral Artery Disease (PAD)| September 20, 2017
September 20, 2017 — Not-for-profit preclinical research institute CBSET announced that its scientists have published
DISRUPT BTK Study Shows Positive Results With Lithoplasty in Calcified Lesions Below the Knee
News | Peripheral Artery Disease (PAD)| September 20, 2017
Shockwave Medical reported positive results from the DISRUPT BTK Study, which were presented at the annual...
Philips Showcases Integrated Vascular Solutions at VIVA 2017
News | Peripheral Artery Disease (PAD)| September 13, 2017
Philips announced its presence at the Vascular Interventional Advances (VIVA 17) Annual Conference in Las Vegas from...
PQ Bypass Reports Positive Results for Detour System in Patients With Long Femoropopliteal Blockages
News | Peripheral Artery Disease (PAD)| September 13, 2017
A subset analysis of the DETOUR I clinical trial showed promising safety and effectiveness results of PQ Bypass’ Detour...
Ra Medical Systems Granted Broad Patent for DABRA Catheter
News | Peripheral Artery Disease (PAD)| August 09, 2017
August 9, 2017 — Ra Medical Systems announced that the United States Patent and Trademark Office (USPTO) has granted
The LimFlow Percutaneous Deep Vein Arterialization System (pDVA) converts veins into arteries to restore blood flow in critical limb ischemia (CLI).

The LimFlow Percutaneous Deep Vein Arterialization System (pDVA) converts veins into arteries to restore blood flow in critical limb ischemia (CLI). This image shows how the covered stents used with the system connect to create a new arterial pathway.

News | Peripheral Artery Disease (PAD)| August 02, 2017
Aug.
Sponsored Content | Videos | Peripheral Artery Disease (PAD)| July 25, 2017
This video case study, provided by Gore Medical, is titled "Tackling Complex Cases in Dialysis Access," by John Ross,
First Patient Treated in U.S. Feasibility Study of LimFlow Critical Limb Ischemia Device
News | Peripheral Artery Disease (PAD)| July 17, 2017
LimFlow SA announced enrollment of the first patient in the U.S. feasibility study of the LimFlow Percutaneous Deep...
Shockwave Medical Announces U.S. Commercial Availability of Lithoplasty System
News | Peripheral Artery Disease (PAD)| June 26, 2017
Shockwave Medical recently announced two milestones for its Lithoplasty System for the treatment of calcified plaque in...
Overlay Init