Avi A Gajjar, John Y Chen, Madeline E Moore, David Tzorfas, Alexandra R Paul
{"title":"液体栓塞剂与颗粒栓塞剂在慢性硬膜下血肿脑膜中动脉栓塞治疗中的成本比较。","authors":"Avi A Gajjar, John Y Chen, Madeline E Moore, David Tzorfas, Alexandra R Paul","doi":"10.1177/15910199251362080","DOIUrl":null,"url":null,"abstract":"<p><p>IntroductionChronic subdural hematomas (cSDH) are increasingly recognized as a major cause of morbidity in aging populations. Procedural Innovations such as middle meningeal artery embolization (MMAE) are becoming more widely adopted for cSDH treatment. While embolization reduces hematoma recurrence, the economic cost of different embolic agents remains unclear. This study evaluates inpatient procedural costs associated with particulate versus liquid embolic materials in MMAE for cSDH.MethodsA retrospective cohort study was conducted at a Comprehensive Stroke Center, including patients who underwent MMAE for cSDH between January 2019 and January 2024. Actual hospital expenditure data was used to assess total procedural and material-specific costs. Clinical outcomes, such as modified Rankin Scale (mRS) scores and 90-day retreatment rates, were compared between embolic agent groups. The primary independent variable was the embolic agent, categorized as particulate or liquid embolics (liquid including Onyx and nBCA).Results114 patients were included, with 18 (15.8%) treated with liquid embolics and 96 (84.2%) treated with particulate embolization. Baseline demographics and procedural variables were largely similar across groups. Procedural costs trended higher for liquid embolization than particulates ($27,419.50 ± $15,851.84 vs. $24,731.24 ± $23,195.37, p = 0.639). Material-specific costs were substantially greater for liquid ($3703.17 ± $1797.85) than to particulates ($152.74 ± $75.91, p < 0.0001). Functional outcomes (mRS at discharge, 30 days, and 90 days) and 90-day retreatment rates were not significantly different between groups. Subgroup analyses of hospital costs and access site also showed no significant differences.ConclusionsParticulate embolic agents offer a cost-effective alternative to liquid embolics for MMAE in cSDH, achieving comparable clinical outcomes at a significantly reduced material cost. Cost-conscious embolic selection may help sustain procedural expansion as MMAE adoption grows.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251362080"},"PeriodicalIF":2.1000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343547/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cost comparison of liquid versus particulate embolic agents for middle meningeal artery embolization in chronic subdural hematoma.\",\"authors\":\"Avi A Gajjar, John Y Chen, Madeline E Moore, David Tzorfas, Alexandra R Paul\",\"doi\":\"10.1177/15910199251362080\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>IntroductionChronic subdural hematomas (cSDH) are increasingly recognized as a major cause of morbidity in aging populations. Procedural Innovations such as middle meningeal artery embolization (MMAE) are becoming more widely adopted for cSDH treatment. While embolization reduces hematoma recurrence, the economic cost of different embolic agents remains unclear. This study evaluates inpatient procedural costs associated with particulate versus liquid embolic materials in MMAE for cSDH.MethodsA retrospective cohort study was conducted at a Comprehensive Stroke Center, including patients who underwent MMAE for cSDH between January 2019 and January 2024. Actual hospital expenditure data was used to assess total procedural and material-specific costs. Clinical outcomes, such as modified Rankin Scale (mRS) scores and 90-day retreatment rates, were compared between embolic agent groups. The primary independent variable was the embolic agent, categorized as particulate or liquid embolics (liquid including Onyx and nBCA).Results114 patients were included, with 18 (15.8%) treated with liquid embolics and 96 (84.2%) treated with particulate embolization. Baseline demographics and procedural variables were largely similar across groups. Procedural costs trended higher for liquid embolization than particulates ($27,419.50 ± $15,851.84 vs. $24,731.24 ± $23,195.37, p = 0.639). Material-specific costs were substantially greater for liquid ($3703.17 ± $1797.85) than to particulates ($152.74 ± $75.91, p < 0.0001). Functional outcomes (mRS at discharge, 30 days, and 90 days) and 90-day retreatment rates were not significantly different between groups. Subgroup analyses of hospital costs and access site also showed no significant differences.ConclusionsParticulate embolic agents offer a cost-effective alternative to liquid embolics for MMAE in cSDH, achieving comparable clinical outcomes at a significantly reduced material cost. Cost-conscious embolic selection may help sustain procedural expansion as MMAE adoption grows.</p>\",\"PeriodicalId\":49174,\"journal\":{\"name\":\"Interventional Neuroradiology\",\"volume\":\" \",\"pages\":\"15910199251362080\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343547/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Interventional Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/15910199251362080\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interventional Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15910199251362080","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
慢性硬膜下血肿(cSDH)越来越被认为是老年人发病的主要原因。脑膜中动脉栓塞(MMAE)等程序性创新正越来越广泛地应用于cSDH治疗。虽然栓塞可以减少血肿复发,但不同栓塞剂的经济成本尚不清楚。本研究评估了颗粒栓塞材料与液体栓塞材料在MMAE治疗cSDH的住院程序成本。方法在综合卒中中心进行回顾性队列研究,包括2019年1月至2024年1月期间因cSDH接受MMAE治疗的患者。实际医院支出数据用于评估总程序和特定材料成本。临床结果,如改良兰金量表(mRS)评分和90天再治疗率,在栓塞剂组之间进行比较。主要自变量是栓塞剂,分为颗粒或液体栓塞剂(液体包括缟玛瑙和nBCA)。结果114例患者中,液体栓塞18例(15.8%),颗粒栓塞96例(84.2%)。基线人口统计数据和程序变量在各组之间基本相似。液体栓塞的手术费用高于颗粒栓塞($27,419.50±$15,851.84 vs $24,731.24±$23,195.37,p = 0.639)。液体材料的成本(3703.17±1797.85美元)明显高于颗粒材料的成本(152.74±75.91美元)
Cost comparison of liquid versus particulate embolic agents for middle meningeal artery embolization in chronic subdural hematoma.
IntroductionChronic subdural hematomas (cSDH) are increasingly recognized as a major cause of morbidity in aging populations. Procedural Innovations such as middle meningeal artery embolization (MMAE) are becoming more widely adopted for cSDH treatment. While embolization reduces hematoma recurrence, the economic cost of different embolic agents remains unclear. This study evaluates inpatient procedural costs associated with particulate versus liquid embolic materials in MMAE for cSDH.MethodsA retrospective cohort study was conducted at a Comprehensive Stroke Center, including patients who underwent MMAE for cSDH between January 2019 and January 2024. Actual hospital expenditure data was used to assess total procedural and material-specific costs. Clinical outcomes, such as modified Rankin Scale (mRS) scores and 90-day retreatment rates, were compared between embolic agent groups. The primary independent variable was the embolic agent, categorized as particulate or liquid embolics (liquid including Onyx and nBCA).Results114 patients were included, with 18 (15.8%) treated with liquid embolics and 96 (84.2%) treated with particulate embolization. Baseline demographics and procedural variables were largely similar across groups. Procedural costs trended higher for liquid embolization than particulates ($27,419.50 ± $15,851.84 vs. $24,731.24 ± $23,195.37, p = 0.639). Material-specific costs were substantially greater for liquid ($3703.17 ± $1797.85) than to particulates ($152.74 ± $75.91, p < 0.0001). Functional outcomes (mRS at discharge, 30 days, and 90 days) and 90-day retreatment rates were not significantly different between groups. Subgroup analyses of hospital costs and access site also showed no significant differences.ConclusionsParticulate embolic agents offer a cost-effective alternative to liquid embolics for MMAE in cSDH, achieving comparable clinical outcomes at a significantly reduced material cost. Cost-conscious embolic selection may help sustain procedural expansion as MMAE adoption grows.
期刊介绍:
Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...