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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/204205
Early exploration of the economic impact of transradial access (TRA) versus transfemoral access (TFA) for neurovascular procedures in Spain
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Introduction Transfemoral access (TFA) is the primary access approach for neurointerventional procedures. Transradial access (TRA) is established in cardiology due to its lower complications, yet, it is at its early stages in neuroprocedures. This study performs an early exploration of the economic impact associated with the introduction of TRA in diagnostic and therapeutic neuroprocedures from the Spanish NHS perspective.Methods An economic model was developed to estimate the cost and clinical implications of using TRA compared to TFA. Costs considered access-related, complications and recovery time costs obtained from local databases and experts' inputs. Clinical inputs were sourced from the literature. A panel of eight experts from different Spanish hospitals, validated or adjusted the values based on local experience. Hypothetical cohorts of 10,000 and 1000 patients were considered for diagnostic and therapeutic neuroprocedures respectively. Deterministic sensitivity analysis was performed.Results TRA in diagnostic procedures was associated with lower costs with savings ranging between euro486 and euro157 depending on the TFA recovery time considered. TRA is estimated to lead to 158 fewer access-site complications. In therapeutic procedures, TRA resulted in 76.4 fewer complications and was estimated to be cost-neutral with an incremental cost of euro21.56 per patient despite recovery times were not included for this group. Variation of the parameters in the sensitivity analysis did not change the direction of the results.Limitations Clinical data was obtained from literature validated by experts therefore results generalizability is limited. In therapeutic neuroprocedures, there is an experience imbalance between approaches and recovery times were not included hence the total impact is not fully captured.Conclusions The early economic model suggests that implementing TRA is associated with reduced costs and complications in diagnostic procedures. In therapeutic procedures, TRA lead to fewer complications and it is estimated to be cost-neutral, however its full potential still needs to be quantified.
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LORENZO GÓRRIZ, Antonio, RODRÍGUEZ PAZ, Carlos, AGUILAR TEJEDOR, Yeray, FANDIÑO, Eduardo, GARCÍA, María jesús, LÓPEZ FRÍAS LÓPEZ JURADO, Alfonso, TOMÁS MUÑOZ, Pablo, PAOLILLO, Rosa, SEGUEL RAVEST, Valeska, BARRANCO PONS, Roger. Early exploration of the economic impact of transradial access (TRA) versus transfemoral access (TFA) for neurovascular procedures in Spain. _Journal of Medical Economics_. 2023. Vol. 26, núm. 1, pàgs. 1445-1454. [consulta: 24 de gener de 2026]. ISSN: 1941-837X. [Disponible a: https://hdl.handle.net/2445/204205]