Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Neurosurgery. 2012 Nov;71(5):944-48; discussion 948-50. doi: 10.1227/NEU.0b013e3182690b8b.
The Pipeline embolization device (PED) is a new endovascular option for wide-necked or fusiform anterior circulation aneurysms that were classically treated by coil embolization with adjunctive use of a stent. However, stent-coiling incurs significant equipment and implant costs.
To determine whether PED embolization is more economical than stent-assisted coiling.
Sixty consecutive patients with anterior circulation aneurysms who underwent treatment with the PED (30 patients) or by single-stage stent-assisted coiling (30 patients) were identified from a prospective single-center aneurysm database. The hospital costs of equipment and implants were analyzed and compared for each group.
The mean aneurysm size for patients treated with the PED was 9.8 vs 7.3 mm for patients treated by stent-assisted coiling. The total combined costs of proximal access/guide catheters, microcatheters, and microwires were equivalent between the 2 groups. The cost of implants, however, was significantly lower in the PED group ($13175 ± 726 vs $19069 ± 2015; P = .013), despite this group having a larger mean aneurysm size. Furthermore, the total procedure cost was significantly lower for the PED group vs the stent-coiling group ($16445 ± 735 vs $22145 ± 2022; P = .02), a 25.7% cost reduction. This represents a 27.1% reduction in the cost per millimeter of aneurysm treated in the PED group ($2261 ± 299) vs the stent-coiling group ($3102 ± 193; P = .02).
Treatment of anterior circulation aneurysms by flow diversion with the PED has lower procedure costs compared with treatment with traditional stent-assisted coiling.
Pipeline 栓塞装置（PED）是一种新的血管内治疗方法，适用于宽颈或梭形的前循环动脉瘤，这些动脉瘤传统上采用线圈栓塞治疗，辅以内置支架。然而，支架线圈植入术需要大量的设备和植入物，成本较高。
确定 PED 栓塞治疗是否比支架辅助线圈植入更经济。
从一个前瞻性的单中心动脉瘤数据库中，确定了 60 例接受 PED（30 例）或单阶段支架辅助线圈植入（30 例）治疗的前循环动脉瘤患者。分析和比较了每组的设备和植入物的医院成本。
接受 PED 治疗的患者的平均动脉瘤大小为 9.8mm，而接受支架辅助线圈植入治疗的患者的平均动脉瘤大小为 7.3mm。近端入路/导引导管、微导管和微导丝的总费用在两组之间是相等的。然而，PED 组的植入物费用明显较低（$13175 ± 726 比$19069 ± 2015；P =.013），尽管该组的平均动脉瘤较大。此外，PED 组的总手术费用明显低于支架线圈组（$16445 ± 735 比$22145 ± 2022；P =.02），降低了 25.7%。这代表在 PED 组（$2261 ± 299）每治疗 1 毫米动脉瘤的成本比支架线圈组（$3102 ± 193）降低了 27.1%（P =.02）。
与传统的支架辅助线圈植入治疗相比，PED 治疗前循环动脉瘤的手术费用更低。
