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A Comparison of Costs and Complications of Manual Compression and Vascular Closing Devices in Femoral Cardiac Catheterization Interventions

Julia Walter, Alina Brandes, Moritz F. Sinner, Wolf Rogowski, Larissa Schwarzkopf

Background: VCDs are used in femoral catheterization and said to be safer and less expensive than MC. This study aimed to compare complications and healthcare expenditures between VCD and MC, in diagnostic and interventional femoral catheterization from German claims data.

Methods: The study population came from a German Statutory Health Insurance (SHI). We calculated odds ratios (OR) for complications with logistic regression models. Healthcare expenditures refer to overall SHI expenditures for the hospital stay and were modelled in Generalized Gamma regression models with recycled predictions and confidence intervals. All analyses were stratified by diagnostic or interventional catheterization and adjusted by age, gender, comorbidities, and antiplatelet and anticoagulant medication.

Findings: We found a significantly lower probability for complications for VCD compared to MC in diagnostic catheterization (OR=0.31, p-value=0.02) but not in interventional catheterization (OR=0.98, p-value=0.90). Total adjusted healthcare expenditures were €2,657 for VCD and €2,664 for MC with a difference of €6 (CI=[-141.5, 121.7], p-value=0.92) in diagnostic catheterization. In interventional catheterization healthcare expenditures were €4,380 for VCD and €4,352 for MC with a difference of €28 (CI=[-107.0, 150.2], p-value=0.62).

Conclusions: Our results implicate that using VCDs is associated with a significantly lower probability for complications in diagnostic catheterization, but has no significant association in interventional procedures. Healthcare expenditures for VCD and MC are comparable in both types of catheterization. These results suggest that the application of VCD is particularly beneficial in diagnostic catheterization from a payer perspective.