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Peripheral Arterial Disease Costlier to Treat Than Heart Trouble

Prolonged recovery, potential for repeat treatments to blame, study finds

WEDNESDAY, Jan. 23 (HealthDay News) -- It costs about 5 percent more to treat people with peripheral arterial disease (PAD) than those with coronary artery disease (CAD), a U.S. study finds.

Both PAD (blocked abdomen and leg arteries) and CAD (blocked heart arteries) are treated with the same methods, including medication, surgery and endovascular techniques such as balloon angiography and stenting. The type of treatment depends on the location and severity of the disease.

Treatment tends to be more successful in CAD patients, which may explain why PAD costs more to treat, the study authors said.

"Patients with heart disease who get treated with a stent typically are doing just fine when seen six to 12 months later," principal investigator Dr. Michael R. Jaff, director of the Massachusetts General Hospital Vascular Center in Boston, said in a prepared statement. "Patients with PAD have to be seen frequently, and many of the treatments don't last as long, so it costs more to care for these patients."

This is because PAD-related blockages tend to be longer and more spread out, while CAD-related blockages are short and near the origin of the arteries.

In this study, Jaff and colleagues analyzed Medicare costs from 1999 to 2005 and found that, on average, the cost of initial treatment and one year of follow-up for PAD patients was $50,110, compared with $47,515 for CAD patients.

The researchers also noted that PAD is on the rise in the United States. About 8.2 percent of the Medicare patients included in the study had PAD in 1999, compared with about 9.5 percent in 2005. Most of the PAD patients were aged 65 or older.

Among the other findings from the study:

  • PAD patients with diabetes cost more to treat than those without diabetes, likely because those with diabetes have more extensive and severe PAD due to the effects of diabetes. About one-third of people with diabetes who are 50 or older have PAD, according to the American Diabetes Association.
  • Minimally invasive endovascular treatment tended to be more successful than surgery in PAD patients. This may be due to the prolonged recovery time for surgery and the potential for repeated treatments.

"These data suggest that future trials of PAD therapy should take into account the high cost of treating these patients, particularly those with diabetes mellitus," Jaff said. "When therapies work equally well, but there are cost advantages of one over the other, the less expensive therapy should be tried first."

The study was presented Monday at the annual International Symposium on Endovascular Therapy, in Hollywood, Fla.

About 8 million to 12 million Americans have PAD, which increases the risk of other cardiovascular disease, such as heart attack, stroke and aneurysm. PAD symptoms include limb pain, especially when walking, as well as numbness, skin discoloration and open sores that don't heal. However, many people with PAD have no symptoms.

More information

The Society for Vascular Surgery has more about peripheral arterial disease.

-- Robert Preidt

SOURCE: International Symposium on Endovascular Therapy, news release, Jan. 21, 2008

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