Comparison of the resource utilization between simultaneous strategy and staged strategy to treat two-vessel coronary artery disease by percutaneous coronary intervention

The purpose of this study was to compare medical resource use, such as total device cost, total contrast volume, and total fluoroscopy time between the staged and simultaneous strategies for treating two-vessel disease (2VD) by percutaneous coronary intervention (PCI).

2VD can be treated by the staged strategy or the simultaneous strategy. Compared to the staged strategy, the simultaneous strategy may reduce medical resource use.

We identified a staged group (138 patients) and simultaneous group (62 patients) from our PCI database between January 1, 2008 and December 31, 2010. Total PCI device cost, total contrast volume, and total fluoroscopy time were compared between the two groups.

Total costs for the staged group and the simultaneous group given in United States dollars were $21,289 ± 5633 and $16,571 ± 5530, respectively (P<.0001). Total contrast volumes for the staged group and the simultaneous group were 299 ± 79 mL and 194 ± 62 mL, respectively (P<.0001). Total fluoroscopy times for the staged group and the simultaneous group were 60 ± 27 minutes and 40 ± 15 minutes, respectively (P<.0001). In multivariate analysis, the simultaneous strategy was significantly associated with low cost, small contrast volume, and short fluoroscopy time even after controlling for age, sex, acute coronary syndrome, and lesion complexity.

Compared to the staged strategy to treat 2VD by PCI, the simultaneous strategy reduced medical resource use, i.e., total device cost, total contrast volume, and total fluoroscopy time.