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Manual Compression versus Vascular Closing Device for Closing Access Puncture Site in Femoral Left-Heart

Julia Walter1, Matthias Vogl2, Martin Holderried3

  • 1Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|June 5, 2017
PubMed

Insights

Vascular closing devices (VCDs) significantly reduce complication rates and costs in interventional catheterization. Their cost-effectiveness also supports wider use in diagnostic catheterization, though hospital stay duration remains unchanged.

Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Health Economics

Background:

  • Catheterization procedures carry risks of complications and associated costs.
  • Manual compression is a traditional method for achieving hemostasis post-catheterization.
  • Vascular closing devices (VCDs) offer an alternative to manual compression for hemostasis.

Purpose of the Study:

  • To compare complication rates, hospital stay length, and costs between manual compression and VCDs.
  • To evaluate VCD efficacy in both diagnostic and interventional catheterization.
  • To assess the economic impact of VCDs in a German university hospital setting.

Main Methods:

  • Retrospective, cross-sectional, single-center study.
  • Stratified analysis by risk profiles and propensity score adjustment.
  • Generalized linear models with gamma distribution for cost and length of stay analysis.

Main Results:

  • VCDs significantly lowered complication rates in interventional catheterization (RR=0.44).
  • VCDs resulted in lower average costs for both diagnostic (€275) and interventional (€373) catheterization.
  • No significant difference in length of hospital stay was observed between VCDs and manual compression.

Conclusions:

  • Vascular closing devices are effective in reducing complications and costs for interventional catheterization.
  • The cost savings associated with VCDs justify their broader implementation in diagnostic catheterization.
  • VCDs represent a valuable tool for improving efficiency and patient outcomes in cardiac catheterization procedures.
Abstract

Keywords:
cost comparisonlength of staymanual compressionrisk of complicationvascular closing device

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