Endovascular aortic repair for abdominal aortic aneurysm and the medical fees of the National Health Insurance

Abstract

We compared the medical fees of the National Health Insurance of conventional open surgery with that of endovascular aortic repair in patients with abdominal aortic aneurysm. Endovascular aortic repair was undergone in 14 patients (Zenith®；5 cases, Excluder®；9 cases) and was compared with open surgery in 15 patients. The medical fees of endovascular aortic repair and open surgery were 3,188,600 yen and 2,085,590 yen, respectively. The main reason for the higher fee of endovascular aortic repair is the graft cost. The material costs of endovascular aortic repair and open surgery were 1,853,500 yen and 251,330 yen. As a whole, the margin of profit of endovascular aortic repair was smaller than that of open surgery by about 1,500 yen/patient/day. Most patients undergoing endovascular aortic repair could walk and take oral intake from the first postoperative day, and the postoperative cost including infusion, medication, and labor was very small. With this convenience, the number of patients with abdominal aortic aneurysm increased 1.9 times after introduction of endovascular aortic repair.