Aim: The incremental cost of peripheral orbital atherectomy system (OAS) plus balloon angioplasty (BA) versus BA-only for critical limb ischemia was estimated.
Materials & methods: A deterministic simulation model used clinical and healthcare utilization data from the CALCIUM 360° trial and current cost data. Incremental cost of OAS + BA versus BA-only included differential utilization during the procedure and adverse-event costs at 3, 6 and 12-months.
Results: For every 100 procedures, incremental annual costs to the hospital were US$350,930 lower with OAS + BA compared with BA-only. Despite higher upfront costs, savings were realized due to reduced need for revascularization, amputation and end-of-life care over 6-12-month postoperative period.
Conclusion: Atherectomy with OAS prior to BA was associated with cost savings to the hospital.
Keywords: CALCIUM 360° trial; Diamondback 360 peripheral orbital atherectomy; adverse event costs; balloon angioplasty; below-the-knee calcification; economic analysis; percutaneous transluminal angioplasty.