Transcatheter Arterialization of the Deep Veins for Chronic Limb-Threatening Ischemia: A Case Series of the Direct Cost Associated With Limb Salvage

Abstract

Our study aims to estimate the long-term cost of procedurally successful transcatheter arterialization of the deep veins (TADV) coupled with adjunct therapy. Patients with no conventional endovascular/open options were considered for TADV. TADV index procedure cost, cost of subsequent procedures and wound care/adjuncts were collected. Cost data were obtained from Medicare claims and other published sources. All patients in the study had limb salvage 180 days after TADV. Success was defined as lime salvage with no more than a transmetatarsal amputation of the affected limb. The average cost of the procedure was $320,850. The average hospital cost (hospitalization and wound care adjuncts) was $895,546. The overall average total cost was $1,216,396. TADV and associated multidisciplinary wound care approach for “no option” chronic limb-threatening ischemia does not appear to be a cost-effective strategy, with an average total cost of over 1 million dollars per patient.