The Comparative Study On The Efficacy And Cost Of Domestic And Imported Abdominal Aortic Stents

Objective: Due to the high cost of covered stent and limited evidence-based medical data,the popularity of abdominal aortic aneurysm repair in China is hinered.In order to reduce the cost of treatment of abdominal aortic aneurysm,localization of stents-graft is imperative,however,the current domestic abdominal aortic aneurysm stents-graft evidence-based medical data is still less,this article aims to compare the new domestic coated stents with imported resin coated stents(GORE EXCLUDER)in the real world under the treatment of kidney type of the clinical curative effect of patients with abdominal aortic aneurysm.Methods:Retrospective analysis of patients with subrenal abdominal aortic aneurysms who underwent endovascular repair in the affiliated hospital of Qingdao university from March 2017 to April 2018.(1)incomplete follow-up data were excluded.(2)patients with abdominal aortic aneurysm rupture;(3)patients with abdominal aortic aneurysm with tumor neck < 1.5cm;(4)patients with malignant tumor or life expectancy < 2 years;(5)infectious,inflammatory or congenital abdominal aortic aneurysm;A total of 74 patients met the criteria for selection.There were 39 cases of domestic film cover stents,2 cases of women,and 37 cases of men.The average was(68.18±9.25)years old,23 cases of hypertension,5 cases of diabetes,and coronary heart disease.11 cases;There were 35 c ases,7 cases of women,28 cases of men,an average(68.60±8.35)years old,24 cases of hypertension,11 cases of coronary heart disease,and 9 cases of diabetes.The general conditions of the two groups of patients were compared: including 1)demographic characteristics;3)aneurysm diameter etc.,and continuous follow-up for 12-24 months.The patient observation indexes include: reoperation intervention including intracavitary and surgical treatment,aneurysm rupture;The incidence of stent-related complications(internal leakage,stent displacement,occlusion),perioperative temperature,creatinine changes;Operation time;Hospita costs;the day in hospital.Result: There was no significant difference in baseline data between the two groups(P>0.05): there were 39 patients in the domestic stent group,37 male patients,and 2 female patients,aged 54-80 years old,with an average of(68.18±9.25)years old;A total of 35 patients in the stent group,including 26 male patients and 9 female patients,aged 52-79 years,mean(68.60±8.35)years old.In the comorbidities there was no significant difference between the two groups(P>0.05).In the perioperative operation between the two groups there was no significant difference(P>0.05): the success rate of the two groups was 100%,the operation time They were 59.97±11.22 min,58.20±12.06 min,P=0.514,and the average number of stents was 2.46±0.60,2.43±0.6,P=0.822,and the diameter of aneurysm was 6.05±0.69 cm,6.13±0.80 cm.P=0.659;hospitalization days were 8.38±5.05 days,7.60±2.52 days,P=0.409;there was no statistically significant difference between the two groups(P>0.05).Followup results: total leakage occurred in the domestic stent group 6 cases,4 cases of type I endoleak(4/10%),2 cases of type II endoleak(2/5%),1 case of reintervention,5 cases of endoleak in the imported stent group,3 cases of type I endoleak(3/9%),type II endoleak in 3 cases(2/6%),and 3 cases of intervention again,the difference was not statistically significant.There was 1 case of sacral occlusion in the domestic group,and either stent displacement or death occurred in group.The cost of surgery in the domestic group was(118420.30±16579.87)rmb,and the cost of surgery in the imported group was(169302.90±10945.71)rmb.The cost of surgery in the imported group was higher than that in the domestic group(P<0.05).Conclusion: domestic covered stent(MicroPort Shanghai)and imported covered stent(GORE EXCLUDER)have similar and safe and effective clinical efficacy in the two-year treatment of patients with subrenal abdominal aortic aneurysm.The treatment cost of the domestic group is significantly lower than that of the imported group,and the domestic covered stent can replace the imported covered stent.