Cost-effectiveness of bypass surgery versus stenting in patients with multivessel coronary artery disease

Yock, Cynthia A.; Boothroyd, Derek B.; Owens, Douglas K; Garber, Alan M.; Hlatky, Mark A.

doi:10.1016/s0002-9343(03)00296-1

Cited by 54 publications

(30 citation statements)

References 49 publications

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“…These results are different to some previously published works, but agree with the study of Yock et al [21].…”

Section: Resultscontrasting

confidence: 70%

“…But, independently of the use of balloons, CIS and, over the last years, DCIS, the number of re-interventions has been the greatest obstacle of the PTA procedure [15][16][17]. Another point considered has been the cost of these procedures [18], which has been unfavorable in respect to the CABG over the first years [19], with the exception of some groups [17,20,21].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

<![CDATA[Myocardial revascularization: comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty]]>

Almeida¹

2005

Braz. j. cardiovasc. surg.

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Revascularização do miocárdio: estudo comparativo do custo da cirurgia convencional e da angioplastia transluminal percutâneaMyocardial revascularization: comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty 143 ALMEIDA, RMS -Myocardial revascularization: comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty Braz J Cardiovasc Surg 2005; 20(2): 142-148

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“…These results are different to some previously published works, but agree with the study of Yock et al [21].…”

Section: Resultscontrasting

confidence: 70%

Section: Resultsmentioning

confidence: 99%

<![CDATA[Myocardial revascularization: comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty]]>

Almeida¹

2005

Braz. j. cardiovasc. surg.

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show abstract

“…In the Markov model the HRQoL values for the chronic conditions were drawn from Danish and American community based preference weights [19,20]. Temporary HRQoL decrements for repeat revascularization were drawn from a previous cost-effectiveness comparing CABG and stenting [21]. In the Markov model the HRQoL for health states other than "Asymptomatic" were estimated using the decrements shown in Table 3.…”

Section: Qalysmentioning

confidence: 99%

Long-term Cost-effectiveness of Endoscopic vs Open Vein Harvest for Coronary Artery Bypass Grafting

Oddershede

Ehlers²,

Andreasen³

2015

J Cardiovasc Dis Diagn

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Background: The greater saphenous vein is frequently used as a conduit for coronary artery bypass grafting (CABG). Previously, veins were most often harvested using open vein harvesting (OVH), however, endoscopic vein harvesting (EVH) techniques have become increasingly popular. Nevertheless, the long-term cost-effectiveness of EVH remains unknown. The present study estimated the long-term cost-effectiveness of EVH versus OVH for CABG.

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“…It is estimated that nearly 95% of all angioplasties (with or without stenting) performed in the United States annually have initially successful outcomes, where success is defined as prevention of death or the need for an emergency CABG [65]. Stenting, which involves the deployment of a tubular mesh structure in an occluded vessel, has improved this success rate by reducing the need for emergency CABG from ~6% to less than 1% [87]. The FDA originally approved coronary stents for use when the results of angioplasty were suboptimal [87].…”

Section: Cad Treatment Optionsmentioning

confidence: 99%

“…Stenting, which involves the deployment of a tubular mesh structure in an occluded vessel, has improved this success rate by reducing the need for emergency CABG from ~6% to less than 1% [87]. The FDA originally approved coronary stents for use when the results of angioplasty were suboptimal [87]. Their use has since increased with approximately 91%…”

Section: Cad Treatment Optionsmentioning

confidence: 99%

Implementation of Physiologic Flow Conditions in a Blood Vessel Mimic Bioreactor System for the Evaluation of Intravascular Devices

Dawson¹

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The prevalence and devastating nature of cardiovascular diseases has led to many advancements in the therapies used to treat the millions of patients that suffer as a result of these conditions. As coronary artery disease (CAD) is the most common of these cardiovascular conditions, it is a major focus of research among the medical industry.Although lifestyle changes and drug therapies can treat early CAD, more advanced cases often require more definitive interventions. In conjunction with angioplasty, stenting of an occluded vessel has shown significant success in preventing restenosis. However, as with nearly every therapeutic process in the medical field, several complications have arisen in stented patients that pose a need for further improvement of the devices. As a result, the stent industry is constantly striving towards improving the characteristics and outcome of their product and with these efforts comes the need for extensive testing and research.Continuous improvement and innovation in the field of tissue engineering has brought about the possibility of creating laboratory grown tissue engineered vascular grafts (TEVGs) for the purpose of replacing and/or bypassing damaged or occluded v regions of the vasculature. By employing the techniques used to produce TEVGs, a blood vessel mimic (BVM) bioreactor system has been developed with the intent of using the resulting construct as a model for testing the cellular response of a human blood vessel to an intravascular device such as a stent. This would allow gathering of more significant data in the early stages of device development and may reduce the overall costs and time required to refine a design.Although the BVM system has previously been used to cultivate viable constructs that were subsequently used to observe the response to a deployed stent, the flow conditions within the original design are not representative of the physiologic conditions in a native vessel. This aspect of the original system presented a need for development in order to be considered by researchers as an accurate in vitro representation of the target vessels in which the stents are used. One of the primary concerns of this environment is creating and maintaining physiologic flow conditions that will represent those present in native vessels in order to facilitate cells sodded on the construct to grow as they would under native conditions. The two key aspects of flow are pulsatility and wall shear stress.Studies in this thesis were carried out to determine the best and most feasible methods for implementing appropriate levels of pulsation and wall shear stress in the previously established BVM bioreactor system with the intention of maintaining the original system's simplicity and high throughput potential. Pulsatile flow was created by elevating backpressure in the BVM chamber while using a different pump head and pump tubing. Wall shear stress was adjusted by altering the viscosity of the perfusate and flow rate through the system. Both pulsatile flow and shear stress were est...

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Cost-effectiveness of bypass surgery versus stenting in patients with multivessel coronary artery disease

Cited by 54 publications

References 49 publications

<![CDATA[<B>Myocardial revascularization</B>: <B>comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty</B>]]>

<![CDATA[<B>Myocardial revascularization</B>: <B>comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty</B>]]>

Long-term Cost-effectiveness of Endoscopic vs Open Vein Harvest for Coronary Artery Bypass Grafting

Implementation of Physiologic Flow Conditions in a Blood Vessel Mimic Bioreactor System for the Evaluation of Intravascular Devices

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