Kobayashi Y, De Gregorio J, Yamamoto Y, Komiyama N, Miyazaki A, Masuda Y
Division of Interventional Cardiology, Lenox Hill Hospital, New York, USA.
Jpn Circ J. 2000 Mar;64(3):161-4. doi: 10.1253/jcj.64.161.
The present study evaluated the cost of coronary stenting compared with conventional balloon angioplasty in Japan. Procedural cost was estimated as the sum of the procedural fee and the cost of devices such as angioplasty balloon and stent. The data such as the number of balloon catheters and stents used, and the rate of crossovers that was shown by the Stent Restenosis Study (STRESS) were applied to calculate the costs of stenting and conventional balloon angioplasty. For the estimation of hospital room and nursing costs, the length of the in-hospital stay was estimated at 7 days. The costs of procedures such as laboratory and radiological tests were determined based on routine coronary intervention at Chiba University Hospital. The rates of target lesion revascularization in the STRESS trial (conventional balloon angioplasty: 21%, stenting: 15%) were used to calculate the cost during follow up. The in-hospital costs of conventional balloon angioplasty and stenting were estimated to be Yens 982,300 and Yens 1,416,893, respectively. The overall costs, including follow-up cost, of conventional balloon angioplasty and stenting were estimated to be Yens 1,188,583 and Yens 1,564,238, respectively. The in-hospital cost of stenting is higher compared with conventional balloon angioplasty because of greater balloon use and direct stent cost. Lower target lesion revascularization reduces the cost difference between conventional balloon angioplasty and stenting, but the higher initial cost of stenting is not fully offset.
本研究评估了在日本冠状动脉支架置入术与传统球囊血管成形术相比的成本。手术成本估计为手术费用与血管成形术球囊和支架等器械成本之和。使用诸如所使用的球囊导管和支架数量以及支架再狭窄研究（STRESS）显示的交叉率等数据来计算支架置入术和传统球囊血管成形术的成本。为了估计病房和护理成本，住院时间估计为7天。诸如实验室和放射学检查等手术的成本是根据千叶大学医院的常规冠状动脉介入治疗确定的。STRESS试验中的靶病变血运重建率（传统球囊血管成形术：21%，支架置入术：15%）用于计算随访期间的成本。传统球囊血管成形术和支架置入术的住院成本估计分别为982,300日元和1,416,893日元。包括随访成本在内的传统球囊血管成形术和支架置入术的总成本估计分别为1,188,583日元和1,564,238日元。由于球囊使用量更大和支架直接成本，支架置入术的住院成本高于传统球囊血管成形术。较低的靶病变血运重建减少了传统球囊血管成形术和支架置入术之间的成本差异，但支架置入术较高的初始成本并未得到完全抵消。
