OBJECTIVES : To compare length of stay (LOS) and costs among patients undergoing procedures requiring closure of large bore arterial access using the Perclose ProGlide® Suture-Mediated Closure System (ProGlide) versus manual surgical cutdown (Cutdown) in a real-world setting.

METHODS : This retrospective study analyzed patients undergoing procedures that require arterial closure (Transcatheter Aortic Valve Replacement/Repair (TAVR), Endovascular Abdominal Aortic Aneurysm Repair (AAA), Thoracic Endovascular Aortic Repair (TAA), or Balloon Aortic Valvuloplasty (BAV)) from 2013 -2017 in the IBM Explorys Research Database. Patients receiving ProGlide during the procedure were directly matched and compared to patients treated by the same providers that were closed via manual surgical cutdown. The LOS for the procedure admission and procedure complications were assessed. Costs per day of admission were estimated using claims data from TAVR, AAA, TAA, or BAV procedure admissions in the Truven Health MarketScan Research Database. A generalized linear model was used to quantify the cost associated with differences in LOS.

RESULTS : A total of 839 ProGlide patients and 839 matched Cutdown patients met the inclusion criteria. Proglide patients experienced lower rates of complications, including infection. Average LOS for ProGlide patients was nearly four days shorter than Cutdown patients (mean: 9.0 vs. 5.1 days; median: 7.0 vs. 3.0; p<0.001). While controlling for index procedure, age, and gender, LOS was a significant predictor of costs, with each day associated with a 4% increase in total cost for the hospitalization (p<0.05). Using the difference in median LOS, predicted total costs for the procedure admission were $20,599 lower among ProGlide patients compared to Cutdown.

CONCLUSIONS : The use of Perclose ProGlide was associated with significantly shorter length of stay for the procedure admission compared to surgical Cutdown. Future analyses should focus on directly quantifying the cost-savings and patient benefit from lower complication rates and shortened LOS.