KAROTİS ARTER STENOZU TEDAVİ TEKNİKLERİNİN MALİYET VE KLİNİK ETKİLİLİĞİNİ İNCELEYEN ÇALIŞMALARIN SİSTEMATİK DERLEMESİ
Author :
Abstract
Bu araştırmanın amacı, karotis arter stenozu tedavisinde kullanılan tedavi tekniklerinden olan karotis stentlemenin, karotis endarterektomiye klinik ve ekonomik etkililik bakımından eşdeğer olup olmadığını sistematik derleme düzeyinde araştırmaktır. Klinik-etkililik için randomize kontrollü çalışmalar sistematik olarak derlenmiştir. Araştırmada ölçülmek istenen temel sonuçlar inme, miyokard enfarktüsü ve mortalite olgularıdır. Ekonomik değerlendirme için karotis stentleme ve karotis endarterektomiyi maliyet-fayda ya da maliyet-etkililik bakımından karşılaştıran çalışmalara yer verilmiştir. Araştırmada tedavi sonrası kısa ve orta dönem inme, stentleme grubunda yüksek iken; miyokard enfarktüsü, endarterektomide daha yüksek seyretmiştir. Mortalite olgusu ise her iki teknikte benzer ya da yakın sonuç üretmiştir. Ekonomik değerlendirme bakımından tedavi teknikleri değerlendirildiğinde, stentleme yönteminin işlem maliyetlerinin yüksekliğinden dolayı endarterektomi karşısında beklenen faydayı sağlayamamıştır. Karotis endarterektomi birçok çalışmada karotis stentlemeye göre daha maliyet-etkin olmuştur.
Keywords
Abstract
The goal of this study was to determine whether carotid stenting is equivalent to carotid endarterectomy in terms of clinical and economic effectiveness at the level of systematic review. In the study, randomized controlled trials have been systematically reviewed for clinical- effectiveness. The primary end point was stroke, myocardial infarction, or death from any cause during the peri-procedural and post-procedural period. For economic evaluation, studies comparing carotid stenting and carotid endarterectomy in terms of cost-benefit or cost-effectiveness are ranked. In the study, while the short and medium term stroke rate after treatment was high in the stenting group, in contrast, myocardial infarction was higher in endarterectomy. However, the case of mortality has been similar or akin to in both techniques. When evaluated in terms of economic evaluation, due to the high cost of the stenting method, it could not provide the expected benefit against endarterectomy. As a result, carotid endarterectomy has been more cost-effective than carotid stenting in many studies in terms of economic evaluation.
Keywords
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