Back to 2025 Display Posters
Impact Of Postoperative Complications On The Cost Of Physician Modified Fenestrated Branched Endovascular Repair Of Complex Abdominal And Thoracoabdominal Aortic Aneurysms
Zachary T. Rengel, M.D.
1, Herbert James, III, M.D.
1, Alyssa Pyun, M.D.
1, Tze-Woei Tan, M.B.B.S.
1, Sarah Sternbach, B.S.
1, Clayton Brinster, M.D.
2, Jacquelyn Paige, NP-C
1, Sukgu Han, M.D.
1.
1University of Southern California, Los Angeles, CA, USA,
2University of Chicago, Chicago, IL, USA.
OBJECTIVES: Physician Modified Fenestrated Branched Endovascular Aortic Repair (PM-FBEVAR) is widely utilized to repair complex abdominal (cAAA) and thoracoabdominal aortic aneurysms (TAAA). Previous studies have highlighted that current Medicare reimbursement models inadequately cover the high costs associated with PM-FBEVAR. This study aims to quantify the costs associated with PM-FBEVAR and clinical outcomes.
METHODS: Consecutive patients who underwent PM-FBEVAR at a regional aortic center between 2019 and 2022 were included. Postoperative major adverse events (MAE) were recorded according to reporting standards. MAEs were categorized into cardiopulmonary, reno-visceral, and neurological among the survivors. The total costs of the index hospitalization included the implant, operating room (OR), intensive care unit (ICU) and other ancillary care. Direct costs by individual components were compared based on the postoperative MAE.
RESULTS: Among 228 patients included in the study, in hospital mortality was seen in 15 patients (6.6%). Among the 213 survivors, 30 (14%) patients experienced 71 MAE. The overall mean direct cost of in-hospital care of patients undergoing PM-FBEVAR was $164,766 (range: $39,745-$806,230). Mean in-hospital total cost among patients experiencing MAE was more than double of those without MAE ($294,431 vs $143,509, P= <.0001), mainly driven by tripled ICU days and ancillary costs. The implant cost was the dominant contributor in patients without MAE, while the ICU cost became dominant in those with MAE.
CONCLUSIONS: Patients who have an MAE after undergoing PM-FBEVAR more than doubles index hospitalization expenses thus highlighting the critical impact of postoperative complications on healthcare expenditure in this patient population.
Back to 2025 Display Posters
