Cost-effectiveness of Vascular Access for Haemodialysis: Arteriovenous Fistulas Versus Arteriovenous Grafts

Leermakers JJPM, Bode AS, Vaidya A, et al (Maastricht Univ Med Ctr (MUMC), The Netherlands; Maastricht Univ, The Netherlands) Eur J Vasc Endovasc Surg 45:84-92, 2013^§

Abstract

Background

The use of an arteriovenous fistula (AVF) for haemodialysis treatment may be associated with a high early failure rate, but usually good long-term patency, while using an arteriovenous graft (AVG) yields a lower early failure rate with worse long-term patency. The aim of this study was to calculate and compare the costs and outcome of AVF and AVG surgery in terms of early and long-term patencies.

Methods

A decision tree and a Markov model were constructed to calculate costs and performance of AVFs and AVGs. The model was populated with a retrospective cohort of HD patients receiving their first VA. The outcomes were determined probabilistically with a 5-year follow-up.

Results

AVFs were usable for a mean (95% CI) of 28.5 months (24.6–32.5 months), while AVGs showed a patency of 25.5 months (20.0–31.2 months). The use of AVFs was the dominant type of VA and €631 could be saved per patient/per month patency compared to AVG use. Regardless of the willingness to pay, the use of AVFs yielded a higher probability of being cost-effective compared to AVGs.

Only gold members can continue reading. Log In or Register to continue

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Facebook (Opens in new window)

Related

Related posts:

1. Muscle Adaptation in Response to Supervised Exercise Training for Intermittent Claudication
2. Follow-Up of Endovascular Treatment for Trans-Atlantic Inter-Society Consensus II Type B Iliac Lesions in Patients Aged <50 Years
3. of Gender and Age on Outcomes of Tibial Artery Endovascular Interventions in Critical Limb Ischemia
4. of Descending Aortic Pathology and Evaluation of the Impact of Thoracic Endovascular Aortic Repair: A Population-based Study in England and Wales from 1999 to 2010

Stay updated, free articles. Join our Telegram channel

Join