Ökonomische Analysen in der
Interventionellen Radiologie

 

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Zusammenfassung

Abwägungen zwischen Kosten und medizinischer Wirkung gewinnen auch in der Interventionellen Radiologie zunehmend an Bedeutung. In dieser Übersichtsarbeit soll der Versuch unternommen werden, bisher publizierte Ergebnisse zu einigen häufiger angewendeten Interventionen zusammenfassend zu referieren. Ausgenommen sind neuroradiologische und koronarvaskuläre Interventionen. Wegen der insgesamt noch relativ geringen Datenmenge zu dem Thema wurden alle zum Thema relevanten Artikel referiert (n = 46) ohne Selektion nach methodischer Qualität. Für eine Reihe von radiologischen Interventionen konnte bereits Kosteneffektivität nachgewiesen werden, so z. B. für die Therapie femoropoplitealer und iliakaler Stenosen mit PTA, für Stenosen der Nierenarterien mit Stent, für den Cava-Filter und die Behandlung von malignen Ösophagus- und Gallenwegsstenosen mit Metallstents. Bei der Therapie des Bauchaortenaneurysmas liegen derzeit divergierende Teilergebnisse vor; hier müssen zukünftige Studien noch Klarheit schaffen. Bei den Iliakalgefäßen liegt bislang keine vergleichende Kosten-Effektivitäts-Analyse vor, die Bypass versus PTA + Stent untersucht, so dass auch hier noch abschließende Ergebnisse abgewartet werden müssen.

Abstract

Considerations about the relation between benefit and expenses are also gaining increasing importance in interventional radiology. This review aims at providing a survey about the published data concerning economical analyses of some of the more frequently employed interventions in radiology excluding neuroradiological and coronary interventions. Because of the relative scarcity of literature in this field, all identified articles (n = 46) were included without selection for methodological quality. For a number of radiological interventions the cost-effectiveness has already been demonstrated, e. g., PTA of femoropopliteal and iliac artery stenoses, stenting of renal artery stenoses, placement of vena-cava filters, as well as metal stents in malignant biliary and esophageal obstructions. Conflicting data exist for the treatment of abdominal aortic aneurysms. So far, no analysis could be found that directly compares bypass surgery versus PTA + stent in iliac arteries.

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Prof. Dr. Stephan Hoyt Duda

Abt. für Radiologische Diagnostik

Hoppe-Seyler-Straße 3

72076 Tübingen

Phone: 07071-298-5841

Fax: 07071-29-5845

Email: stephan.duda@med.uni-tuebingen.de