The High Costs of Intra-Cranial Angioplasty

Angioplasty and stenting of intra-cranial vessels (blood vessels in the skull that supply blood to the brain) is linked to nearly triple the cost of regular care for stroke, according to a new study.

Furthermore the safety and efficacy of these two procedures remain uncertain.

Researchers from Rush University analyzed data (healthcare records) on more than 370,000 patients from 2005 to 2007 at 1,000 hospitals participating in the National Inpatient Survey. The study marks the first large-scale nationwide review of intra-cranial stenting and angioplasty, in which a balloon-tipped catheter is threaded into the brain and inflated to reopen a blocked vessel.

The findings indicate high risk of complications and limited evidence pointing to the procedures' safety and effectiveness, said Yousef Mohammad, M.D., M.Sc., the study’s lead author, and an associate professor of neurology and director of the Stroke Fellowship Program at Rush University in Chicago.

A total of 158 patients (average age 64, 54 percent male) underwent angioplasty, and 169 patients (average age 62, 50 percent male) underwent angioplasty plus stenting (in which a tiny mesh tube is placed in the blocked artery to open it up).

Mortality rates for those who underwent angioplasty was 16 percent, and 4 percent for those who underwent both procedures.

Costs for in-hospital stays with angioplasty was $89,175 and $61,050 for angioplasty-plus-stent compared to $24,303 without the surgery.

Stoke is the third-leading cause of death in the U.S. and the leading cause of long-term disability. There are three types of stroke (ischemic caused by blood clots, hemorrhagic caused by bleeding in the brain and transient ischemic attacks). Symptoms, which require immediate medical attention, include difficulty speaking or understanding speech (aphasia); difficulty walking; dizziness or lightheadedness (vertigo); and numbness, paralysis or weakness, usually on one side of the body.