Critical limb ischemia (CLI) is a clinical syndrome of ischemic pain at rest or tissue loss, such as non-healing ulcers or gangrene, related to PAD disease. CLI has a high short-term risk of limb amputation. Mortality after amputation is extremely high and is increased in diabetic patients. An Endovascular first approach is often recommended based on a lower procedural risk. Current endovascular treatment consists in balloon angioplasty (BA) prior to an stent implantation.

OBJECTIVE: To determine whether the use of the Orbital Atherectomy System for CLI patients can be a technology that generates savings for Spanish public health institutions compared to the currently used treatment (BA). In particular, the study is presented in the context of the Hospital Sant Pau which is a reference center in the treatment of CLI patients.

METHODS:

The purpose of ‘Hospital cost impact of orbital atherectomy with angioplasty for critical limb ischemia treatment: a modeling approach’ (1) was to determine cost-effectiveness of (OAS+BA) vs current treatment (BA) in US. In order to generate a local Budget Impact Analyses (BIA), the model was run with local data from a reference center. By considering the use of resources per CLI patient at the Hospital de Sant Pau, and the consumable unit costs, the (BIA) was prepared to demonstrate cost savings for the hospital.

RESULTS:(OAS + BA) treatment for CLI patients, proves to be cost-saving vs current treatment (BA) in Hospital de Sant Pau, capable to generate savings per patient of 3,647€. The results were consistent compared to the current international literature where it has been demonstrated the superiority in incremental QALYs and incremental free-of-amputation years of life.(1) (2)

CONCLUSIONS: (OAS+BA) should be the first choice for the treatment of CLI patients in Spain, due to its ability to generate savings for public health institutions and medical benefits for patients.